更新

2026-08-27 14:23:23 +08:00
parent b5b14516a1
commit 2fa8492c56
27 changed files with 3832 additions and 1435 deletions
@@ -5,8 +5,9 @@ from __future__ import annotations
 import logging
 import os
 import sys
-import time
-from contextlib import suppress
+import time
+from collections.abc import Mapping, Sequence
+from contextlib import suppress
 from typing import Any

 from PySide6.QtCore import QLibraryInfo, QLocale, QObject, Qt, QTimer, QTranslator
@@ -34,17 +35,179 @@ from doctor_workstation.services import (
    build_repository,
 )
 from doctor_workstation.ui import LoginWindow, ShellWindow, apply_theme
-from doctor_workstation.ui.dialogs.app_update import AppUpdateSession
-from doctor_workstation.ui.widgets import (
-    friendly_error,
-    run_async,
+from doctor_workstation.ui.dialogs.app_update import AppUpdateSession
+from doctor_workstation.ui.widgets import (
+    first_value,
+    friendly_error,
+    gender_text,
+    get_value,
+    run_async,
    set_authentication_expired_handler,
    show_toast,
 )
 from doctor_workstation.video import BackendMode, launch_video_call
 from doctor_workstation.video.window import WEBENGINE_AVAILABLE

-LOGGER = logging.getLogger(__name__)
+LOGGER = logging.getLogger(__name__)
+
+
+def _video_case_text(value: Any, *, limit: int = 2000) -> str:
+    """Render a bounded, JSON-safe clinical value for the trusted call rail."""
+
+    if value in (None, "", [], {}):
+        return ""
+    if isinstance(value, Mapping):
+        parts = [
+            f"{key}：{_video_case_text(item, limit=limit)}"
+            for key, item in value.items()
+            if item not in (None, "", [], {})
+        ]
+        return "；".join(part for part in parts if not part.endswith("："))[:limit]
+    if isinstance(value, Sequence) and not isinstance(value, (str, bytes, bytearray)):
+        return "、".join(
+            part
+            for item in value
+            if (part := _video_case_text(item, limit=limit))
+        )[:limit]
+    return str(value).strip()[:limit]
+
+
+def _video_identity(value: Any) -> str:
+    if value in (None, "") or isinstance(value, bool):
+        return ""
+    text = str(value).strip()
+    if not text:
+        return ""
+    with suppress(ValueError, TypeError):
+        return str(int(text))
+    return text
+
+
+def _video_identity_matches(expected: Any, actual: Any) -> bool:
+    normalized_actual = _video_identity(actual)
+    return not normalized_actual or normalized_actual == _video_identity(expected)
+
+
+def _build_video_patient_case(
+    detail: Any,
+    fallback_record: Any,
+    *,
+    diagnosis_id: Any,
+    patient_id: Any,
+    patient_name: str,
+) -> dict[str, str]:
+    """Reduce the readonly diagnosis aggregate to the fields needed in-call."""
+
+    if isinstance(detail, Mapping) and not get_value(detail, "diagnosis", None):
+        nested = get_value(detail, "data", None)
+        if isinstance(nested, Mapping):
+            detail = nested
+    diagnosis = get_value(detail, "diagnosis", None)
+    if not diagnosis and isinstance(detail, Mapping):
+        diagnosis = detail
+    diagnosis = diagnosis or {}
+    patient = get_value(detail, "patient", None) or {}
+    appointment = get_value(detail, "appointment", None) or {}
+
+    detail_diagnosis_id = first_value(diagnosis, "id", "diagnosis_id", default=None)
+    detail_patient_id = first_value(
+        diagnosis,
+        "source_patient_id",
+        default=first_value(
+            patient,
+            "source_patient_id",
+            default=None,
+        ),
+    )
+    if not _video_identity_matches(
+        diagnosis_id,
+        detail_diagnosis_id,
+    ) or not _video_identity_matches(patient_id, detail_patient_id):
+        detail = diagnosis = patient = appointment = {}
+
+    fallback_diagnosis_id = first_value(
+        fallback_record,
+        "diagnosis_id",
+        "id",
+        default=None,
+    )
+    fallback_patient_id = first_value(
+        fallback_record,
+        "source_patient_id",
+        "patient_id",
+        default=None,
+    )
+    if not _video_identity_matches(
+        diagnosis_id,
+        fallback_diagnosis_id,
+    ) or not _video_identity_matches(patient_id, fallback_patient_id):
+        fallback_record = {}
+    sources = (diagnosis, patient, appointment, fallback_record)
+
+    def pick(*keys: str, limit: int = 2000) -> str:
+        for source in sources:
+            value = first_value(source, *keys, default=None)
+            text = _video_case_text(value, limit=limit)
+            if text:
+                return text
+        return ""
+
+    raw_gender = next(
+        (
+            first_value(source, "gender_desc", "gender", default=None)
+            for source in sources
+            if first_value(source, "gender_desc", "gender", default=None) not in (None, "")
+        ),
+        None,
+    )
+    return {
+        "diagnosisId": _video_case_text(diagnosis_id, limit=80),
+        "name": pick("patient_name", "name", limit=120)
+        or _video_case_text(patient_name, limit=120)
+        or "患者",
+        "gender": "" if raw_gender in (None, "") else gender_text(raw_gender),
+        "age": pick("age", limit=20),
+        "height": pick("height", limit=20),
+        "weight": pick("weight", limit=20),
+        "diagnosisDate": pick("diagnosis_date", "diagnosis_date_text", limit=80),
+        "appointmentDate": pick(
+            "appointment_date",
+            "latest_appointment_date",
+            limit=80,
+        ),
+        "clinicalDiagnosis": pick(
+            "clinical_diagnosis",
+            "diagnosis_name",
+            "disease_name",
+        ),
+        "chiefComplaint": pick("chief_complaint", "complaint"),
+        "presentIllness": pick("present_illness", "present_illness_history", "symptoms"),
+        "pastHistory": pick("past_history_text", "past_history_desc", "past_history"),
+        "allergyHistory": pick(
+            "allergy_history_text",
+            "allergy_history_desc",
+            "allergy_history",
+        ),
+        "personalHistory": pick(
+            "personal_history_text",
+            "personal_history_desc",
+            "personal_history",
+        ),
+        "familyHistory": pick(
+            "family_history_text",
+            "family_history_desc",
+            "family_history",
+        ),
+        "currentMedication": pick(
+            "current_medications",
+            "current_medicine",
+            "current_medication",
+        ),
+        "tongue": pick("tongue", "tongue_coating"),
+        "pulse": pick("pulse", "pulse_condition"),
+        "prescriptionOpinion": pick("prescription_opinion", "prescription_advice"),
+        "remark": pick("remark"),
+    }


 class _ChineseQtTranslator(QTranslator):
@@ -247,9 +410,11 @@ class ApplicationController(QObject):
        self.shell_window: ShellWindow | None = None
        self.current_repository: Any = None
        self.current_demo_mode = config.demo_mode
-        self.video_calls: dict[str, Any] = {}
-        self.video_pending: dict[str, object] = {}
-        self.demo_video_dialogs: dict[str, DemoVideoDialog] = {}
+        self.video_calls: dict[str, Any] = {}
+        self.video_pending: dict[str, object] = {}
+        self.demo_video_dialogs: dict[str, DemoVideoDialog] = {}
+        self._video_preview_state: dict[str, Any] | None = None
+        self._video_preview_generation = 0
        self._restore_generation = 0
        self._restore_in_progress = False
        self._restore_worker: Any = None
@@ -547,16 +712,17 @@ class ApplicationController(QObject):
        self._logout(message="登录状态已失效，请重新登录。")
        return True

-    def _logout(self, *, message: str = "") -> None:
-        """Clear authenticated resources and return to the login window."""
-
-        calls = tuple(self.video_calls.values())
+    def _logout(self, *, message: str = "") -> None:
+        """Clear authenticated resources and return to the login window."""
+
+        self._restore_video_preview(activate=False)
+        calls = tuple(self.video_calls.values())
        for call in calls:
            with suppress(Exception):
                call.close()
        self._wait_for_video_lifecycle(calls, timeout=1.25)
-        self.video_calls.clear()
-        self.video_pending.clear()
+        self.video_calls.clear()
+        self.video_pending.clear()
        for dialog in self.demo_video_dialogs.values():
            dialog.close()
        self.demo_video_dialogs.clear()
@@ -579,7 +745,8 @@ class ApplicationController(QObject):
        patient_id = payload.get("patient_id")
        diagnosis_id = payload.get("diagnosis_id")
        patient_name = str(payload.get("patient_name") or "患者")
-        open_im = str(payload.get("mode") or "video").lower() == "im"
+        open_im = str(payload.get("mode") or "video").lower() == "im"
+        fallback_record = payload.get("record")
        if patient_id in (None, "") or diagnosis_id in (None, ""):
            show_toast(parent, "患者或诊单信息不完整，无法发起视频。", "danger", 4200)
            return
@@ -633,27 +800,49 @@ class ApplicationController(QObject):
        marker = object()
        self.video_pending[call_key] = marker

-        def get_ticket() -> Any:
-            return repository.get_call_ticket(
-                patient_id=int(patient_id),
-                diagnosis_id=int(diagnosis_id),
-            )
+        def get_video_context() -> tuple[Any, dict[str, str]]:
+            ticket = repository.get_call_ticket(
+                patient_id=int(patient_id),
+                diagnosis_id=int(diagnosis_id),
+            )
+            detail: Any = {}
+            detail_loader = getattr(repository, "patient_detail", None)
+            if callable(detail_loader):
+                try:
+                    detail = detail_loader(int(diagnosis_id))
+                except Exception as error:
+                    LOGGER.warning(
+                        "patient detail could not be loaded for video call",
+                        extra={
+                            "diagnosis_id": diagnosis_id,
+                            "error_type": type(error).__name__,
+                        },
+                    )
+            patient_case = _build_video_patient_case(
+                detail,
+                fallback_record,
+                diagnosis_id=diagnosis_id,
+                patient_id=patient_id,
+                patient_name=patient_name,
+            )
+            return ticket, patient_case

        def request_ticket() -> None:
            if self.video_pending.get(call_key) is not marker:
                return
-            run_async(
-                get_ticket,
-                on_success=lambda ticket: self._launch_video(
-                    ticket,
-                    diagnosis_id=diagnosis_id,
-                    patient_id=patient_id,
-                    repository=repository,
+            run_async(
+                get_video_context,
+                on_success=lambda context: self._launch_video(
+                    context[0],
+                    diagnosis_id=diagnosis_id,
+                    patient_id=patient_id,
+                    repository=repository,
                    call_key=call_key,
                    marker=marker,
-                    open_im=open_im,
-                    patient_name=patient_name,
-                ),
+                    open_im=open_im,
+                    patient_name=patient_name,
+                    patient_case=context[1],
+                ),
                on_error=lambda error: self._video_ticket_error(
                    call_key,
                    marker,
@@ -696,8 +885,9 @@ class ApplicationController(QObject):
        repository: Any,
        call_key: str,
        marker: object,
-        open_im: bool = False,
-        patient_name: str = "患者",
+        open_im: bool = False,
+        patient_name: str = "患者",
+        patient_case: Mapping[str, Any] | None = None,
    ) -> None:
        if self.video_pending.get(call_key) is not marker:
            return
@@ -723,9 +913,13 @@ class ApplicationController(QObject):
                local_dist=video_dist_path(),
                remote_url=self.config.video_web_url or None,
                logger=logging.getLogger("doctor_workstation.video"),
-                open_im=open_im,
-                patient_name=patient_name,
-            )
+                open_im=open_im,
+                patient_name=patient_name,
+                patient_case=patient_case,
+                on_open_diagnosis=lambda current_id=diagnosis_id: (
+                    self._open_video_diagnosis(current_id)
+                ),
+            )
        except Exception as error:
            LOGGER.exception("video call could not be launched")
            show_toast(
@@ -734,20 +928,123 @@ class ApplicationController(QObject):
                "danger",
                5600,
            )
-            return
-        self.video_calls[call_key] = call
+            return
+        self.video_calls[call_key] = call
        qt_window = getattr(call, "qt_window", None)
        if qt_window is not None:
            qt_window.destroyed.connect(
                lambda _obj=None, key=call_key, expected=call: self._release_video_call(
                    key,
                    expected,
-                )
-            )
-
-    def _release_video_call(self, call_key: str, call: Any) -> None:
-        if self.video_calls.get(call_key) is call:
-            self.video_calls.pop(call_key, None)
+                )
+            )
+
+    def _open_video_diagnosis(self, diagnosis_id: Any) -> None:
+        """Open the diagnosis while keeping its live video visible as a preview."""
+
+        shell = self.shell_window
+        if shell is None or self.current_repository is None:
+            return
+        dialog = shell.open_diagnosis_by_id(diagnosis_id, modeless=True)
+        if dialog is None:
+            return
+        call = self.video_calls.get(str(diagnosis_id))
+        video_window = getattr(call, "qt_window", None)
+        if video_window is not None:
+            self._show_video_preview(video_window, dialog)
+
+    def _show_video_preview(self, video_window: Any, dialog: QDialog) -> None:
+        """Pin a compact call window above the modeless diagnosis drawer."""
+
+        current = self._video_preview_state
+        if current is not None and current.get("window") is not video_window:
+            self._restore_video_preview(activate=False)
+
+        self._video_preview_generation += 1
+        generation = self._video_preview_generation
+        if current is None or current.get("window") is not video_window:
+            try:
+                state = {
+                    "window": video_window,
+                    "geometry": video_window.geometry(),
+                    "minimum_size": video_window.minimumSize(),
+                    "maximized": video_window.isMaximized(),
+                    "full_screen": video_window.isFullScreen(),
+                    "stays_on_top": bool(
+                        video_window.windowFlags()
+                        & Qt.WindowType.WindowStaysOnTopHint
+                    ),
+                }
+                screen = video_window.screen() or QGuiApplication.primaryScreen()
+                available = screen.availableGeometry()
+                preview_width = min(540, max(460, round(available.width() * 0.29)))
+                preview_height = min(380, max(320, round(preview_width * 0.66)))
+                margin = 18
+
+                video_window.showNormal()
+                video_window.setMinimumSize(440, 300)
+                video_window.setWindowFlag(Qt.WindowType.WindowStaysOnTopHint, True)
+                video_window.resize(preview_width, preview_height)
+                video_window.move(
+                    available.x() + available.width() - preview_width - margin,
+                    available.y() + margin,
+                )
+                video_window.show()
+                self._video_preview_state = state
+            except RuntimeError:
+                self._video_preview_state = None
+                return
+
+        dialog.finished.connect(
+            lambda _result, expected=generation: self._restore_video_preview(expected)
+        )
+        try:
+            video_window.raise_()
+            dialog.raise_()
+            dialog.activateWindow()
+        except RuntimeError:
+            self._video_preview_state = None
+
+    def _restore_video_preview(
+        self,
+        generation: int | None = None,
+        *,
+        activate: bool = True,
+    ) -> None:
+        if generation is not None and generation != self._video_preview_generation:
+            return
+        state = self._video_preview_state
+        if state is None:
+            return
+        self._video_preview_state = None
+        self._video_preview_generation += 1
+        window = state.get("window")
+        try:
+            window.setWindowFlag(
+                Qt.WindowType.WindowStaysOnTopHint,
+                bool(state.get("stays_on_top")),
+            )
+            window.setMinimumSize(state["minimum_size"])
+            window.setGeometry(state["geometry"])
+            if state.get("full_screen"):
+                window.showFullScreen()
+            elif state.get("maximized"):
+                window.showMaximized()
+            else:
+                window.showNormal()
+            window.raise_()
+            if activate:
+                window.activateWindow()
+        except (AttributeError, RuntimeError):
+            return
+
+    def _release_video_call(self, call_key: str, call: Any) -> None:
+        preview = self._video_preview_state
+        if preview is not None and preview.get("window") is getattr(call, "qt_window", None):
+            self._video_preview_state = None
+            self._video_preview_generation += 1
+        if self.video_calls.get(call_key) is call:
+            self.video_calls.pop(call_key, None)

    def _forget_demo_dialog(self, call_key: str, dialog: DemoVideoDialog) -> None:
        if self.demo_video_dialogs.get(call_key) is dialog:
@@ -778,15 +1075,16 @@ class ApplicationController(QObject):
        if icon_file.exists():
            window.setWindowIcon(QIcon(str(icon_file)))

-    def shutdown(self) -> None:
+    def shutdown(self) -> None:
        """Invalidate asynchronous restoration and release owned resources."""

        if self._shutting_down:
            return
        self._shutting_down = True
-        self._cancel_session_restore()
-        set_authentication_expired_handler(None)
-        calls = tuple(self.video_calls.values())
+        self._cancel_session_restore()
+        set_authentication_expired_handler(None)
+        self._restore_video_preview(activate=False)
+        calls = tuple(self.video_calls.values())
        for call in calls:
            with suppress(Exception):
                call.close()
@@ -15,6 +15,7 @@ from urllib.parse import urlsplit
 from PySide6.QtCore import QObject, QPointF, QRunnable, QSize, Qt, QThreadPool, QTimer, Signal, Slot
 from PySide6.QtGui import (
    QColor,
+    QFont,
    QIcon,
    QKeyEvent,
    QPainter,
@@ -22,6 +23,9 @@ from PySide6.QtGui import (
    QPen,
    QPixmap,
    QPolygonF,
+    QTextBlockFormat,
+    QTextCharFormat,
+    QTextCursor,
 )
 from PySide6.QtWidgets import (
    QDialog,
@@ -44,7 +48,7 @@ from PySide6.QtWidgets import (

 from ..diagnosis_drawer import CaseGrid, _RemoteImageButton
 from ..diagnosis_media import open_safe_http_url, safe_http_url
-from ..theme import crisp_pixmap, mark_business_dialog
+from ..theme import apply_reading_rhythm, crisp_pixmap, mark_business_dialog
 from ..widgets import (
    display_text,
    first_value,
@@ -790,14 +794,24 @@ _DOCTOR_DOCUMENT_CSS = (
    "li { margin:3px 0; line-height:1.58; } "
    "a { color:#DDE1FF; } code,pre { color:#FFFFFF; }"
 )
+# 模型回复几乎都是“分节标题 + 两层要点”的长文。早期样式里标题只比正文大 1px、
+# 段落与列表项的间距也几乎相同，整段读起来就是一堵字墙。这里把层级、行距和分节
+# 留白拉开：标题明显更大更重，顶层小节之间留出整行空白，嵌套要点单独收紧缩进。
 _AI_DOCUMENT_CSS = (
-    "body { color:#34436B; font-size:14px; line-height:1.68; } "
-    "h1,h2,h3,h4 { color:#15224A; font-size:15px; margin:12px 0 6px; line-height:1.45; } "
-    "p { margin:6px 0; line-height:1.68; } ul,ol { margin:7px 0 7px 21px; } "
-    "li { margin:4px 0; line-height:1.62; } "
-    "strong { color:#15224A; } a { color:#5B67F1; } "
+    "body { color:#3A4870; font-size:14px; line-height:200%; } "
+    "h1,h2 { color:#111B3F; font-size:17px; margin:22px 0 10px; line-height:160%; } "
+    "h3,h4 { color:#15224A; font-size:15px; margin:18px 0 8px; line-height:160%; } "
+    "p { margin:10px 0; line-height:200%; } "
+    "ol { margin:12px 0 12px 22px; } "
+    "ul { margin:8px 0 8px 20px; } "
+    "li { margin:6px 0; line-height:190%; } "
+    # 顶层小节之间留出整行空白，让四个小节一眼可数。
+    "ol > li { margin:16px 0; } "
+    "ol > li > strong { color:#111B3F; font-size:15px; } "
+    "strong { color:#1B2A55; } a { color:#5B67F1; } "
+    "hr { margin:20px 0; } "
    "code { color:#33406B; background:#EEF1FF; } "
-    "pre { color:#33406B; background:#F0F3FA; margin:8px 0; padding:8px; }"
+    "pre { color:#33406B; background:#F0F3FA; margin:12px 0; padding:10px; }"
 )
 _STRUCTURED_FIELD_LABELS = {
    "diagnosis": "诊断建议",
@@ -1257,6 +1271,7 @@ def render_chat_payload(browser: QTextBrowser, raw: Any, *, role: str = "ai") ->
        return
    if isinstance(raw, (Mapping, list, tuple)):
        browser.setMarkdown(_structured_markdown(raw))
+        apply_reading_rhythm(browser, role=role)
        return
    text = str(raw).strip()
    if not text:
@@ -1269,12 +1284,15 @@ def render_chat_payload(browser: QTextBrowser, raw: Any, *, role: str = "ai") ->
            parsed = None
        if parsed is not None:
            browser.setMarkdown(_structured_markdown(parsed))
+            apply_reading_rhythm(browser, role=role)
            return
    lowered = text[:240].lower()
    if text.startswith("<") and any(marker in lowered for marker in _HTML_MARKERS):
        browser.setHtml(text)
+        apply_reading_rhythm(browser, role=role)
        return
    browser.setMarkdown(text)
+    apply_reading_rhythm(browser, role=role)


 def _unwrap_analysis(payload: Any) -> dict[str, Any]:
@@ -1894,6 +1912,75 @@ def _parse_clinical_analysis(raw: Any) -> _ClinicalAnalysisModel | None:
    )


+#: One section of a generic structured reply: a title plus its bullet points.
+_ReportSection = namedtuple("_ReportSection", "title items")
+
+_REPORT_NUMBERED_RE = re.compile(r"^\s*(\d{1,2})\s*[.、)）]\s*(.+?)\s*$")
+_REPORT_BULLET_RE = re.compile(r"^\s*[-*+•○]\s*(.+?)\s*$")
+
+
+def parse_structured_report(raw: Any) -> tuple[str, tuple[_ReportSection, ...], str] | None:
+    """Split a sectioned reply into ``(intro, sections, disclaimer)``.
+
+    The clinical panel only recognises four fixed section names (证候分析,
+    信息缺口, 建议下一步, 风险提示), so the sectioned answers models actually
+    return — "症状演变与疗效评估", "血糖控制与监测细节", … — fell through to plain
+    text.  This accepts any reply that is genuinely sectioned: two or more
+    numbered or ``#`` headings, each carrying at least one bullet.
+    """
+
+    if not isinstance(raw, str):
+        return None
+    text = raw.strip()
+    if len(text) < 120 or text[0] in "[{<" or "```" in text:
+        return None
+
+    intro: list[str] = []
+    disclaimer: list[str] = []
+    sections: list[_ReportSection] = []
+    collecting_disclaimer = False
+    for line in text.replace("\r\n", "\n").splitlines():
+        stripped = line.strip()
+        if not stripped or set(stripped) <= {"-", "*", "_"}:
+            continue
+        plain = _plain_markdown(stripped)
+        if collecting_disclaimer or plain.startswith(("重要提示", "免责声明", "提示：", "安全提示")):
+            collecting_disclaimer = True
+            disclaimer.append(plain)
+            continue
+
+        bullet = _REPORT_BULLET_RE.match(line)
+        if bullet is not None and sections:
+            sections[-1].items.append(_plain_markdown(bullet.group(1)))
+            continue
+
+        heading = ""
+        if stripped.startswith("#"):
+            heading = _plain_markdown(stripped.lstrip("#").strip())
+        else:
+            numbered = _REPORT_NUMBERED_RE.match(_plain_markdown(stripped))
+            # 顶层小节标题很短；带句号的长句是正文，不是标题。
+            if numbered is not None and len(numbered.group(2)) <= 28:
+                heading = numbered.group(2)
+        if heading:
+            sections.append(_ReportSection(heading, []))
+            continue
+
+        if sections:
+            sections[-1].items.append(plain)
+        elif bullet is None:
+            intro.append(plain)
+
+    usable = [section for section in sections if section.items]
+    if len(usable) < 2:
+        return None
+    return (
+        " ".join(intro).strip(),
+        tuple(_ReportSection(s.title, tuple(s.items)) for s in usable),
+        " ".join(disclaimer).strip(),
+    )
+
+
 _InsightItem = namedtuple("_InsightItem", "kind marker label text")

 _INSIGHT_LIST_RE = re.compile(r"^\s*(\d{1,2})\s*([\.、)）]\s*)")
@@ -2088,6 +2175,110 @@ class _RichMessage(QTextBrowser):
            self._fitting = False


+class _StructuredReportPanel(QWidget):
+    """Scan-first report for any sectioned reply.
+
+    Renders each section as its own card with a numbered chip, so a doctor can
+    count and jump between sections instead of reading a continuous column of
+    bullets.
+    """
+
+    def __init__(
+        self,
+        intro: str,
+        sections: Sequence[_ReportSection],
+        disclaimer: str,
+        *,
+        time_text: str = "",
+        parent: QWidget | None = None,
+    ) -> None:
+        super().__init__(parent)
+        self.setObjectName("AiConsultClinicalPanel")
+        self.setSizePolicy(QSizePolicy.Policy.Expanding, QSizePolicy.Policy.Minimum)
+        self.sections = tuple(sections)
+        root = QVBoxLayout(self)
+        root.setContentsMargins(0, 0, 0, 0)
+        root.setSpacing(12)
+
+        header = QHBoxLayout()
+        header.setContentsMargins(0, 0, 0, 0)
+        header.setSpacing(9)
+        title = QLabel("AI 结构化报告")
+        title.setObjectName("AiConsultClinicalTitle")
+        header.addWidget(title)
+        self.meta_label = QLabel(time_text)
+        self.meta_label.setObjectName("AiConsultClinicalMeta")
+        header.addWidget(self.meta_label)
+        header.addStretch(1)
+        badge = QLabel(f"{len(self.sections)} 个要点")
+        badge.setObjectName("AiConsultClinicalBadge")
+        badge.setSizePolicy(QSizePolicy.Policy.Fixed, QSizePolicy.Policy.Fixed)
+        header.addWidget(badge, 0, Qt.AlignmentFlag.AlignVCenter)
+        root.addLayout(header)
+
+        if intro:
+            summary = QFrame(self)
+            summary.setObjectName("AiConsultClinicalSummary")
+            summary.setSizePolicy(QSizePolicy.Policy.Preferred, QSizePolicy.Policy.Fixed)
+            _style_surface(summary)
+            summary_layout = QVBoxLayout(summary)
+            summary_layout.setContentsMargins(13, 11, 13, 11)
+            summary_layout.setSpacing(4)
+            body = QLabel(intro, summary)
+            body.setObjectName("AiConsultClinicalSummaryBody")
+            body.setWordWrap(True)
+            summary_layout.addWidget(body)
+            root.addWidget(summary)
+
+        for index, section in enumerate(self.sections, start=1):
+            root.addWidget(self._section_card(index, section))
+
+        if disclaimer:
+            note = QLabel(disclaimer, self)
+            note.setObjectName("AiConsultClinicalDisclaimer")
+            note.setWordWrap(True)
+            note.setSizePolicy(QSizePolicy.Policy.Preferred, QSizePolicy.Policy.Fixed)
+            root.addWidget(note)
+        # 富余高度归到底部，否则会被平摊进每张卡片，把报告拉得空空荡荡。
+        root.addStretch(1)
+
+    def _section_card(self, index: int, section: _ReportSection) -> QFrame:
+        card = QFrame(self)
+        card.setObjectName("AiConsultClinicalSection")
+        card.setSizePolicy(QSizePolicy.Policy.Preferred, QSizePolicy.Policy.Fixed)
+        _style_surface(card)
+        layout = QVBoxLayout(card)
+        layout.setContentsMargins(14, 12, 14, 12)
+        layout.setSpacing(8)
+
+        head = QHBoxLayout()
+        head.setContentsMargins(0, 0, 0, 0)
+        head.setSpacing(8)
+        chip = QLabel(str(index), card)
+        chip.setObjectName("AiConsultHypothesisTag")
+        chip.setAlignment(Qt.AlignmentFlag.AlignCenter)
+        head.addWidget(chip)
+        title = QLabel(section.title, card)
+        title.setObjectName("AiConsultClinicalSectionTitle")
+        title.setWordWrap(True)
+        head.addWidget(title, 1)
+        layout.addLayout(head)
+
+        for item in section.items:
+            row = QFrame(card)
+            row.setObjectName("AiConsultGapRow")
+            _style_surface(row)
+            row_layout = QHBoxLayout(row)
+            row_layout.setContentsMargins(11, 9, 11, 9)
+            row_layout.setSpacing(8)
+            body = QLabel(item, row)
+            body.setObjectName("AiConsultClinicalBody")
+            body.setWordWrap(True)
+            row_layout.addWidget(body, 1)
+            layout.addWidget(row)
+        return card
+
+
 class _ClinicalAnalysisPanel(QWidget):
    """High-contrast, scan-first presentation for completed clinical replies."""

@@ -2499,14 +2690,27 @@ class _ChatBubble(QWidget):
        if self._role != "ai" or self.body is None:
            return False
        model = _parse_clinical_analysis(self._raw_payload)
-        if model is None:
+        panel: QWidget | None = None
+        if model is not None:
+            panel = _ClinicalAnalysisPanel(
+                model,
+                time_text=self.stamp.text(),
+                parent=self._bubble_frame,
+            )
+        else:
+            # 临床面板只认四个固定小节名；其余同样分好节的长回复走通用结构化报告，
+            # 而不是退回成一整段纯文本。
+            report = parse_structured_report(self._raw_payload)
+            if report is not None:
+                panel = _StructuredReportPanel(
+                    *report,
+                    time_text=self.stamp.text(),
+                    parent=self._bubble_frame,
+                )
+        if panel is None:
            return False
        self._reset_clinical_panel()
-        panel = _ClinicalAnalysisPanel(
-            model,
-            time_text=self.stamp.text(),
-            parent=self._bubble_frame,
-        )
+        panel.setParent(self._bubble_frame)
        self._clinical_panel = panel
        self._role_name.hide()
        self.stamp.hide()
@@ -2691,6 +2895,14 @@ class _ClickCard(QFrame):
 # the doctor can see exactly what material is going to the model.
 AI_CONTEXT_MAX_CHARS = 320
 AI_PROMPT_LIMIT = 500
+
+#: 首个增量到达前显示的占位文案，避免留下一块没有任何说明的空白气泡。
+AI_STREAM_PENDING_TEXT = "正在生成…"
+
+#: 连接结束但一个字都没收到时的兜底文案。
+AI_STREAM_SILENT_TEXT = (
+    "AI 助手没有返回内容，可能是服务端未响应或连接中断，请稍后重试。"
+)
 AI_CONTEXT_SEPARATOR = "\n\n— 医生提问 —\n"


@@ -2998,6 +3210,10 @@ class AiConsultDialog(QDialog):
        self._patient_ai_context: str = ""
        self._patient_ai_context_labels: list[str] = []
        self._patient_ai_context_bubble: _ChatBubble | None = None
+        # 全量上下文说明每轮问答都一样，只在本次会话第一次提问时提示一次。
+        self._context_notice_shown = False
+        # done 事件是否到达。用于区分“模型没内容”和“连接直接断了”。
+        self._stream_completed = False
        self._follow_chat = True
        self._flush_timer = QTimer(self)
        self._flush_timer.setSingleShot(True)
@@ -3005,6 +3221,14 @@ class AiConsultDialog(QDialog):
        self._flush_timer.timeout.connect(self._flush_stream_chunks)
        self.setObjectName("AiConsultDialog")
        self.setWindowTitle("问诊详情")
+        # QDialog 默认只带关闭按钮，医生无法把这个信息密度很高的窗口放大到整屏。
+        # 显式补上最大化/最小化按钮，并允许拖拽边角调整大小。
+        self.setWindowFlags(
+            self.windowFlags()
+            | Qt.WindowType.WindowMinimizeButtonHint
+            | Qt.WindowType.WindowMaximizeButtonHint
+        )
+        self.setSizeGripEnabled(True)
        self.resize(1280, 820)
        self.setMinimumSize(1080, 680)
        self.setAttribute(Qt.WidgetAttribute.WA_StyledBackground, True)
@@ -3047,6 +3271,8 @@ class AiConsultDialog(QDialog):
        self._patient_ai_context = ""
        self._patient_ai_context_labels = []
        self._patient_ai_context_bubble = None
+        # 换患者等于开启新会话，全量上下文说明需要再提示一次。
+        self._context_notice_shown = False
        # Appointment seeds are presentation hints only.  In the admin list,
        # ``patient_id`` may actually be the diagnosis id, so it must never
        # replace the separately supplied patient owner.
@@ -5281,12 +5507,18 @@ class AiConsultDialog(QDialog):
        self._append_bubble(
            "doctor", text, time_text=datetime.now().strftime("%H:%M")
        )
-        self._append_bubble(
-            "ai",
-            "服务端将按当前诊单实时附带患者全部纵向资料（病历、备注/舌苔、报告、日常记录、视频转写及历史处方）。",
-            time_text="全量上下文",
-        )
-        self._stream_bubble = self._append_bubble("ai", "")
+        if not self._context_notice_shown:
+            self._append_bubble(
+                "ai",
+                "服务端将按当前诊单实时附带患者全部纵向资料"
+                "（病历、备注/舌苔、报告、日常记录、视频转写及历史处方）。",
+                time_text="全量上下文",
+            )
+            self._context_notice_shown = True
+        # 首帧到达前先占位。空气泡在后端无响应时会一直是一块空白卡片，
+        # 医生无法判断是还在生成还是已经失败。
+        self._stream_bubble = self._append_bubble("ai", AI_STREAM_PENDING_TEXT)
+        self._stream_completed = False
        self._stream_text = ""
        self._pending_chunks.clear()
        self._stream_meta.clear()
@@ -5341,6 +5573,7 @@ class AiConsultDialog(QDialog):
        if kind != "done":
            return
        self._stream_meta.update(payload)
+        self._stream_completed = True
        if not self._stream_text and not self._pending_chunks:
            answer = first_value(payload, "answer", "content", default="")
            if answer not in (None, ""):
@@ -5396,6 +5629,16 @@ class AiConsultDialog(QDialog):
            return
        if self._stream_worker is worker:
            self._stream_worker = None
+        # 连接结束却既没有 done 也没有报错时（服务端静默断开），占位气泡会永远
+        # 停在“正在生成…”。这里补一条明确说明，而不是留一块空白卡片。
+        if (
+            not self._stream_completed
+            and not self._stream_text
+            and self._stream_bubble is not None
+        ):
+            self._stream_text = AI_STREAM_SILENT_TEXT
+            self._stream_bubble.set_payload(self._stream_text)
+            self._stream_bubble.set_time_text(datetime.now().strftime("%H:%M"))
        self._asking = False
        self.send_button.setEnabled(True)

@@ -5408,6 +5651,7 @@ class AiConsultDialog(QDialog):
        self._stream_bubble = None
        self._pending_chunks.clear()
        self._stream_text = ""
+        self._stream_completed = False
        self._stream_meta.clear()
        self._asking = False
        self.send_button.setEnabled(True)
@@ -1911,8 +1911,20 @@ class DiagnosisDialog(QDialog):
        )
        present_diagnosis_ai_report(self.repository, self.permissions, self, row)

-    def open_view_only(self, diagnosis_id: int, *, seed: Any = None) -> None:
-        self.open_for(diagnosis_id, editable=False, seed=seed, view_only=True)
+    def open_view_only(
+        self,
+        diagnosis_id: int,
+        *,
+        seed: Any = None,
+        modeless: bool = False,
+    ) -> None:
+        self.open_for(
+            diagnosis_id,
+            editable=False,
+            seed=seed,
+            view_only=True,
+            modeless=modeless,
+        )

    def open_for(
        self,
@@ -1921,6 +1933,7 @@ class DiagnosisDialog(QDialog):
        editable: bool = False,
        seed: Any = None,
        view_only: bool = False,
+        modeless: bool = False,
    ) -> None:
        """Open immediately, then replace the seed with authoritative server data."""

@@ -1973,7 +1986,7 @@ class DiagnosisDialog(QDialog):
        self.view_stack.setCurrentWidget(
            self.readonly_page if self._standalone_readonly else self.drawer_overlay
        )
-        self.setModal(not self._standalone_readonly)
+        self.setModal(not modeless and not self._standalone_readonly)
        self.setWindowTitle(
            "患者信息详情"
            if self._standalone_readonly
@@ -43,6 +43,7 @@ from doctor_workstation.resources import app_icon_path

 from .dialogs.ai_consult import can_open_ai_consult
 from .dialogs.ai_consult_picker import select_and_present_ai_consult
+from .dialogs.diagnosis import DiagnosisDialog
 from .dialogs.local_audio_queue import LocalAudioQueueDialog
 from .pages import (
    AppointmentsPage,
@@ -59,6 +60,7 @@ from .widgets import (
    display_text,
    first_value,
    get_value,
+    has_permission,
    show_toast,
 )

@@ -895,6 +897,7 @@ class ShellWindow(QMainWindow):
        self._activation_generation = 0
        self._activation_refreshed = False
        self._local_audio_settings_dialog: LocalAudioQueueDialog | None = None
+        self._global_diagnosis_dialog: DiagnosisDialog | None = None

        self.setMinimumSize(_SHELL_MINIMUM_SIZE)
        screen = self.screen() or QApplication.primaryScreen()
@@ -1845,6 +1848,54 @@ class ShellWindow(QMainWindow):
        if callable(refresh):
            refresh()

+    def _ensure_global_diagnosis_dialog(self) -> DiagnosisDialog:
+        dialog = self._global_diagnosis_dialog
+        if dialog is None:
+            dialog = DiagnosisDialog(
+                self.repository,
+                self,
+                permissions=self.permissions,
+            )
+            dialog.saved.connect(self.refresh_current_page)
+            self._global_diagnosis_dialog = dialog
+        else:
+            dialog.refresh_permissions(self.permissions)
+        return dialog
+
+    def open_diagnosis_by_id(
+        self,
+        diagnosis_id: Any,
+        *,
+        modeless: bool = False,
+    ) -> DiagnosisDialog | None:
+        """Open one authoritative diagnosis in the strongest permitted mode."""
+
+        try:
+            normalized_id = int(diagnosis_id)
+        except (TypeError, ValueError):
+            normalized_id = 0
+        if normalized_id <= 0:
+            show_toast(self, "当前视频缺少有效诊单编号。", "warning", 3600)
+            return None
+
+        if has_permission(self.permissions, "tcm.diagnosis/edit", default=False):
+            dialog = self._ensure_global_diagnosis_dialog()
+            dialog.open_for(normalized_id, editable=True, modeless=modeless)
+        elif has_permission(
+            self.permissions,
+            "tcm.diagnosis/readonlyDetail",
+            default=False,
+        ):
+            dialog = self._ensure_global_diagnosis_dialog()
+            dialog.open_view_only(normalized_id, modeless=modeless)
+        else:
+            show_toast(self, "当前账号没有查看该诊单的权限。", "danger", 4200)
+            return None
+
+        dialog.raise_()
+        dialog.activateWindow()
+        return dialog
+
    def showEvent(self, event: Any) -> None:  # noqa: N802 - Qt virtual
        super().showEvent(event)
        page = self.stack.currentWidget()
@@ -15,9 +15,19 @@ import os
 import sys
 from pathlib import Path
 from string import Template
+from typing import Any

 from PySide6.QtCore import QEvent, QObject, Qt
-from PySide6.QtGui import QColor, QFont, QFontDatabase, QPalette, QPixmap
+from PySide6.QtGui import (
+    QColor,
+    QFont,
+    QFontDatabase,
+    QPalette,
+    QPixmap,
+    QTextBlockFormat,
+    QTextCharFormat,
+    QTextCursor,
+)
 from PySide6.QtWidgets import (
    QApplication,
    QDialog,
@@ -25,6 +35,7 @@ from PySide6.QtWidgets import (
    QFileDialog,
    QInputDialog,
    QMessageBox,
+    QTextBrowser,
 )

 # Canonical semantic tokens.  The legacy teal/ink aliases remain available to
@@ -997,6 +1008,111 @@ QToolTip {
 ).substitute(_QSS_TOKENS)


+#: Per-block reading rhythm, in device pixels.  ``(top, bottom, line%)``.
+#: QTextDocument's markdown importer builds block formats directly and ignores
+#: ``setDefaultStyleSheet``, so spacing has to be applied to the parsed
+#: document instead of being declared in CSS.
+# 行内收紧、行间放开：一条要点自己的折行必须比两条要点之间更紧，否则整段会散成
+# 一行一行的碎片，反而更难读。
+_BLOCK_RHYTHM = {
+    "heading": (22, 10, 148),
+    "subheading": (18, 8, 148),
+    # 顶层列表项通常就是小节标题，之间留出整行空白让各小节一眼可数。
+    "section": (20, 8, 150),
+    "item": (13, 5, 158),      # nested bullet under a section
+    "paragraph": (10, 10, 168),
+}
+
+
+def _block_is_all_bold(block: Any) -> bool:
+    """True when every visible run in the block is bold.
+
+    Models title their sections as ``1. **症状演变与疗效评估**`` rather than as
+    real markdown headings, so a fully bold top-level list item is the only
+    reliable signal that a block is a section title and not a content bullet.
+    """
+
+    iterator = block.begin()
+    seen = False
+    while not iterator.atEnd():
+        fragment = iterator.fragment()
+        iterator += 1
+        if not fragment.isValid() or not fragment.text().strip():
+            continue
+        seen = True
+        if fragment.charFormat().fontWeight() < QFont.Weight.DemiBold.value:
+            return False
+    return seen
+
+
+def apply_reading_rhythm(browser: QTextBrowser, *, role: str) -> None:
+    """Give a parsed reply real hierarchy and breathing room.
+
+    Model answers are long "section heading + two levels of bullets" documents.
+    Qt renders every one of those blocks at the same size with 6px margins, so
+    the reply arrives as a wall of text.  This walks the parsed document once
+    and applies a heading scale plus per-level spacing.
+    """
+
+    document = browser.document()
+    base_font = browser.font()
+    base_px = base_font.pixelSize()
+    if base_px <= 0:
+        base_px = max(12, round(base_font.pointSizeF() * 96 / 72))
+
+    cursor = QTextCursor(document)
+    cursor.beginEditBlock()
+    try:
+        block = document.begin()
+        while block.isValid():
+            heading = block.blockFormat().headingLevel()
+            text_list = block.textList()
+            indent = text_list.format().indent() if text_list is not None else 0
+            if heading:
+                kind = "heading" if heading <= 2 else "subheading"
+                size = base_px + (3 if heading <= 2 else 1)
+            elif indent >= 2:
+                kind, size = "item", None
+            elif indent == 1:
+                kind = "section"
+                # 只有整行加粗的顶层条目才是小节标题，普通要点保持正文字号。
+                size = base_px + 2 if _block_is_all_bold(block) else None
+            else:
+                kind, size = "paragraph", None
+
+            top, bottom, line = _BLOCK_RHYTHM[kind]
+            # 首块的上边距会在气泡顶部留出一段空白，视觉上像是排版错位。
+            if block.position() == 0:
+                top = 0
+            block_format = QTextBlockFormat(block.blockFormat())
+            block_format.setTopMargin(top)
+            block_format.setBottomMargin(bottom)
+            block_format.setLineHeight(
+                line, QTextBlockFormat.LineHeightTypes.ProportionalHeight.value
+            )
+            cursor.setPosition(block.position())
+            cursor.setBlockFormat(block_format)
+
+            if size is not None and block.length() > 1:
+                heading_font = QFont(base_font)
+                heading_font.setPixelSize(size)
+                heading_font.setBold(True)
+                char_format = QTextCharFormat()
+                char_format.setFont(heading_font)
+                if role != "doctor":
+                    char_format.setForeground(QColor("#111B3F"))
+                cursor.setPosition(block.position())
+                cursor.setPosition(
+                    block.position() + block.length() - 1,
+                    QTextCursor.MoveMode.KeepAnchor,
+                )
+                cursor.mergeCharFormat(char_format)
+            block = block.next()
+    finally:
+        cursor.endEditBlock()
+
+
+
 def _apply_group(
    palette: QPalette,
    group: QPalette.ColorGroup,
@@ -1085,17 +1201,48 @@ def _polish_dialog_buttons(button_box: QDialogButtonBox) -> None:
        _refresh_widget_style(button)


+def allow_dialog_resize(dialog: QDialog) -> None:
+    """Give a business subwindow the usual minimise/maximise affordances.
+
+    ``QDialog`` ships with a close button only, so every AI panel, report and
+    editor was stuck at whatever size it was constructed with — unusable for the
+    long, dense clinical replies these windows carry.  Transient prompts
+    (message and input boxes) are deliberately left alone, and a dialog that has
+    pinned itself to a fixed size keeps that decision.
+    """
+
+    if isinstance(dialog, (QMessageBox, QInputDialog, QFileDialog)):
+        return
+    if dialog.minimumSize() == dialog.maximumSize():
+        return
+    # Qt hides a window whose flags change while it is visible, so a dialog that
+    # is already on screen keeps the flags it was shown with.
+    if dialog.isVisible():
+        dialog.setSizeGripEnabled(True)
+        return
+    flags = dialog.windowFlags()
+    if flags & Qt.WindowType.WindowMaximizeButtonHint:
+        return
+    dialog.setWindowFlags(
+        flags
+        | Qt.WindowType.WindowMinimizeButtonHint
+        | Qt.WindowType.WindowMaximizeButtonHint
+    )
+    dialog.setSizeGripEnabled(True)
+
+
 def mark_business_dialog(dialog: QDialog, object_name: str | None = None) -> None:
    """Opt a business subwindow into the shared visual contract.

    The helper intentionally does not change modality, ownership or result
-    handling.  It only supplies stable styling metadata and semantic button
-    roles, so existing workflows keep their original behavior.
+    handling.  It only supplies stable styling metadata, semantic button roles
+    and window affordances, so existing workflows keep their original behavior.
    """

    if object_name and not dialog.objectName():
        dialog.setObjectName(object_name)
    dialog.setProperty("businessDialog", True)
+    allow_dialog_resize(dialog)
    for button_box in dialog.findChildren(QDialogButtonBox):
        _polish_dialog_buttons(button_box)
    _refresh_widget_style(dialog)
@@ -1119,6 +1266,12 @@ class _BusinessDialogStyleFilter(QObject):
            QEvent.Type.Show,
        }:
            _polish_dialog_buttons(watched)
+        elif isinstance(watched, QDialog) and event_type == QEvent.Type.Polish:
+            # Window flags can only be changed before the dialog is on screen,
+            # so dynamically-created dialogs get their affordances at polish
+            # time rather than when they are already visible.
+            if not self._is_native_or_overlay(watched):
+                allow_dialog_resize(watched)
        elif isinstance(watched, QDialog) and event_type == QEvent.Type.Show:
            for button_box in watched.findChildren(QDialogButtonBox):
                _polish_dialog_buttons(button_box)
@@ -1215,6 +1368,8 @@ def apply_theme(app: QApplication) -> None:

 __all__ = [
    "COLORS",
+    "allow_dialog_resize",
+    "apply_reading_rhythm",
    "GLOBAL_QSS",
    "METRICS",
    "TYPE",
@@ -378,6 +378,8 @@ class VideoCallLauncher:
        patient_id: Any = None,
        open_im: bool = False,
        patient_name: str = "患者",
+        patient_case: Mapping[str, Any] | None = None,
+        on_open_diagnosis: Callable[[], None] | None = None,
    ) -> Any:
        request = self.prepare(
            ticket,
@@ -395,6 +397,8 @@ class VideoCallLauncher:
            browser_opener=self.browser_opener,
            open_im=open_im,
            patient_name=patient_name,
+            patient_case=patient_case,
+            on_open_diagnosis=on_open_diagnosis,
        )


@@ -411,6 +415,8 @@ def launch_video_call(
    browser_opener: Callable[[str], bool] | None = None,
    open_im: bool = False,
    patient_name: str = "患者",
+    patient_case: Mapping[str, Any] | None = None,
+    on_open_diagnosis: Callable[[], None] | None = None,
 ) -> Any:
    """Normalize a ticket and open a call with the requested backend."""

@@ -427,4 +433,6 @@ def launch_video_call(
        patient_id=patient_id,
        open_im=open_im,
        patient_name=patient_name,
+        patient_case=patient_case,
+        on_open_diagnosis=on_open_diagnosis,
    )
@@ -296,6 +296,8 @@ if WEBENGINE_AVAILABLE:  # pragma: no cover - GUI behavior needs an integration
            lifecycle_factory: Callable[[], OrderedCallLifecycle],
            open_im: bool = False,
            patient_name: str = "患者",
+            patient_case: Mapping[str, Any] | None = None,
+            on_open_diagnosis: Callable[[], None] | None = None,
        ) -> None:
            super().__init__()
            self.request = request
@@ -306,6 +308,8 @@ if WEBENGINE_AVAILABLE:  # pragma: no cover - GUI behavior needs an integration
            self.logger = logger
            self.open_im = bool(open_im)
            self.patient_name = str(patient_name or "患者").strip() or "患者"
+            self.patient_case = dict(patient_case or {})
+            self._on_open_diagnosis = on_open_diagnosis
            try:
                self._policy = TrustedDocumentPolicy.from_url(
                    location.url,
@@ -451,6 +455,7 @@ if WEBENGINE_AVAILABLE:  # pragma: no cover - GUI behavior needs an integration
            config = {
                **self.request.to_web_config(),
                "patientName": self.patient_name,
+                "patientCase": self.patient_case,
                "mode": "chat" if self.open_im else "video",
            }
            config_json = json.dumps(config, ensure_ascii=True, separators=(",", ":"))
@@ -499,6 +504,10 @@ if WEBENGINE_AVAILABLE:  # pragma: no cover - GUI behavior needs an integration
            if self._closing:
                return
            event = str(message.get("event", ""))
+            if event == "open-diagnosis-request":
+                if self._on_open_diagnosis is not None:
+                    QTimer.singleShot(0, self._open_diagnosis_safely)
+                return
            if event == "call-start-request":
                self._start_call_cycle()
                return
@@ -580,6 +589,17 @@ if WEBENGINE_AVAILABLE:  # pragma: no cover - GUI behavior needs an integration
                if not self.open_im or self._shutdown_requested:
                    self._close_from_companion("companion-error")

+        def _open_diagnosis_safely(self) -> None:
+            if self._closing or self._on_open_diagnosis is None:
+                return
+            try:
+                self._on_open_diagnosis()
+            except Exception:
+                self.logger.exception(
+                    "diagnosis drawer could not be opened from video companion",
+                    extra={"video_call": self.request.safe_log_context()},
+                )
+
        def _notify_room_completed(self, room_id: str, future: Future[bool]) -> None:
            try:
                succeeded = bool(future.result())
@@ -1214,6 +1234,8 @@ class VideoCallWindow:
        browser_opener: Callable[[str], bool] | None = None,
        open_im: bool = False,
        patient_name: str = "患者",
+        patient_case: Mapping[str, Any] | None = None,
+        on_open_diagnosis: Callable[[], None] | None = None,
    ) -> None:
        del browser_opener  # Reserved for a future authenticated handoff implementation.
        try:
@@ -1231,6 +1253,8 @@ class VideoCallWindow:
        self.repository = repository
        self.open_im = bool(open_im)
        self.patient_name = str(patient_name or "患者").strip() or "患者"
+        self.patient_case = dict(patient_case or {})
+        self.on_open_diagnosis = on_open_diagnosis
        self.logger = logger or _LOGGER
        self.location = resolve_companion_location(
            local_dist=local_dist,
@@ -1259,6 +1283,8 @@ class VideoCallWindow:
                lifecycle_factory=self._new_lifecycle,
                open_im=self.open_im,
                patient_name=self.patient_name,
+                patient_case=self.patient_case,
+                on_open_diagnosis=self.on_open_diagnosis,
            )
        except Exception:
            self.lifecycle.end("window-open-failed")
@@ -1302,6 +1328,8 @@ def open_video_call(
    browser_opener: Callable[[str], bool] | None = None,
    open_im: bool = False,
    patient_name: str = "患者",
+    patient_case: Mapping[str, Any] | None = None,
+    on_open_diagnosis: Callable[[], None] | None = None,
 ) -> VideoCallWindow:
    """Create and immediately open a trusted embedded video window."""

@@ -1316,6 +1344,8 @@ def open_video_call(
        browser_opener=browser_opener,
        open_im=open_im,
        patient_name=patient_name,
+        patient_case=patient_case,
+        on_open_diagnosis=on_open_diagnosis,
    ).open()


@@ -1291,3 +1291,234 @@ def test_ask_sends_only_question_and_relies_on_server_full_context(
    assert any("请结合资料分析当前证候" in text for text in all_bubble_texts)
    assert any("服务端将按当前诊单实时附带患者全部纵向资料" in text for text in all_bubble_texts)
    dialog.close()
+
+
+def _bubble_texts(dialog: AiConsultDialog) -> list[str]:
+    return [
+        widget.toPlainText()
+        for widget in dialog.findChildren(QTextBrowser)
+        if widget.objectName() == "AiConsultBubbleText"
+    ]
+
+
+def _silent_dialog(monkeypatch: pytest.MonkeyPatch) -> AiConsultDialog:
+    """A dialog whose stream workers are never actually started."""
+
+    monkeypatch.setattr(
+        ai_consult_module,
+        "QThreadPool",
+        SimpleNamespace(
+            globalInstance=lambda: SimpleNamespace(start=lambda worker: None)
+        ),
+    )
+    dialog = AiConsultDialog(
+        DemoDoctorRepository(),
+        PermissionSet(["tcm.diagnosis/aiAssistant"]),
+    )
+    dialog.open_for(diagnosis_id=501, patient_id=301)
+    return dialog
+
+
+def test_full_context_notice_is_shown_once_per_conversation(
+    application: QApplication,
+    monkeypatch: pytest.MonkeyPatch,
+) -> None:
+    # 每轮问答都重复同一句全量上下文说明会把真正的回答挤出可视区。
+    dialog = _silent_dialog(monkeypatch)
+    dialog.show()
+    application.processEvents()
+
+    notice = "服务端将按当前诊单实时附带患者全部纵向资料"
+    counts = []
+    for question in ("第一个问题", "第二个问题", "第三个问题"):
+        dialog._cancel_stream()
+        dialog._ask(question)
+        counts.append(sum(1 for text in _bubble_texts(dialog) if notice in text))
+    assert counts == [1, 1, 1]
+
+    # 换患者视为新会话，需要重新提示一次。
+    dialog.open_for(diagnosis_id=502, patient_id=302)
+    application.processEvents()
+    dialog._ask("新患者的问题")
+    assert sum(1 for text in _bubble_texts(dialog) if notice in text) == 1
+    dialog.close()
+
+
+def test_pending_and_silently_closed_streams_never_show_a_blank_bubble(
+    application: QApplication,
+    monkeypatch: pytest.MonkeyPatch,
+) -> None:
+    # 服务端既不发 done 也不报错时，占位气泡会永远停在空白状态。
+    dialog = _silent_dialog(monkeypatch)
+    dialog.show()
+    application.processEvents()
+
+    dialog._ask("请评估当前用药是否合理")
+    assert dialog._stream_bubble is not None
+    assert dialog._stream_bubble._raw_payload == ai_consult_module.AI_STREAM_PENDING_TEXT
+    assert any(
+        ai_consult_module.AI_STREAM_PENDING_TEXT in text for text in _bubble_texts(dialog)
+    )
+
+    dialog._stream_finished(
+        dialog._generation, dialog._stream_generation, dialog._stream_worker
+    )
+    application.processEvents()
+    assert dialog._stream_text == ai_consult_module.AI_STREAM_SILENT_TEXT
+    assert any(ai_consult_module.AI_STREAM_SILENT_TEXT in text for text in _bubble_texts(dialog))
+    assert dialog.send_button.isEnabled()
+    dialog.close()
+
+
+def test_answered_stream_replaces_the_pending_placeholder(
+    application: QApplication,
+    monkeypatch: pytest.MonkeyPatch,
+) -> None:
+    dialog = _silent_dialog(monkeypatch)
+    dialog.show()
+    application.processEvents()
+
+    dialog._ask("请总结当前病情")
+    generation, stream_generation = dialog._generation, dialog._stream_generation
+    dialog._stream_event(generation, stream_generation, {"event": "delta", "text": "证候："})
+    dialog._stream_event(generation, stream_generation, {"event": "delta", "text": "脾肾两虚"})
+    dialog._stream_event(generation, stream_generation, {"event": "done", "model_label": "千问"})
+    dialog._stream_finished(generation, stream_generation, dialog._stream_worker)
+    application.processEvents()
+
+    assert dialog._stream_text == "证候：脾肾两虚"
+    texts = _bubble_texts(dialog)
+    assert not any(ai_consult_module.AI_STREAM_PENDING_TEXT in text for text in texts)
+    assert not any(ai_consult_module.AI_STREAM_SILENT_TEXT in text for text in texts)
+    dialog.close()
+
+
+def test_ai_consult_window_can_be_maximized(
+    application: QApplication,
+    monkeypatch: pytest.MonkeyPatch,
+) -> None:
+    # 这个窗口信息密度很高，必须允许医生放大到整屏。
+    dialog = _silent_dialog(monkeypatch)
+    flags = dialog.windowFlags()
+    assert flags & Qt.WindowType.WindowMaximizeButtonHint
+    assert flags & Qt.WindowType.WindowMinimizeButtonHint
+    assert dialog.isSizeGripEnabled()
+    dialog.showMaximized()
+    application.processEvents()
+    assert dialog.isMaximized()
+    dialog.close()
+
+
+def test_long_reply_gets_section_hierarchy_and_breathing_room(
+    application: QApplication,
+) -> None:
+    """QTextDocument's markdown importer ignores setDefaultStyleSheet.
+
+    Spacing therefore has to be applied to the parsed document; without it every
+    block renders at one size with 6px margins and the reply reads as a wall.
+    """
+
+    browser = ai_consult_module._RichMessage("ai")
+    browser.resize(660, 400)
+    browser.set_payload(
+        "概述段落。\n\n"
+        "1. **症状演变与疗效评估**\n"
+        "   - **麻木症状：** 服药十四天后是否缓解？\n"
+        "   - **皮肤瘙痒：** 目前是否仍有发作？\n"
+        "2. **血糖控制与监测细节**\n"
+        "   - **监测习惯：** 是否规律监测餐后血糖？\n"
+    )
+
+    document = browser.document()
+    base_px = browser.font().pixelSize()
+    seen: dict[str, list] = {"section": [], "item": [], "paragraph": []}
+    block = document.begin()
+    while block.isValid():
+        text_list = block.textList()
+        indent = text_list.format().indent() if text_list is not None else 0
+        kind = "item" if indent >= 2 else "section" if indent == 1 else "paragraph"
+        seen[kind].append(block)
+        block = block.next()
+
+    assert seen["section"] and seen["item"], "both list levels must be present"
+
+    # 小节标题比正文更大更重，否则四个小节无法一眼分辨。
+    section = seen["section"][0]
+    section_size = section.begin().fragment().charFormat().font().pixelSize()
+    assert section_size > base_px
+
+    # 小节之间的留白必须大于同一小节内要点之间的留白。
+    section_top = seen["section"][0].blockFormat().topMargin()
+    item_top = seen["item"][0].blockFormat().topMargin()
+    assert section_top > item_top > 0
+
+    # 一条要点的折行必须比两条要点之间更紧，否则整段会散成碎片。
+    item_line = seen["item"][0].blockFormat().lineHeight()
+    assert 0 < item_line < 170
+
+    # 首块不带上边距，避免气泡顶部出现一段空白。
+    assert document.begin().blockFormat().topMargin() == 0
+
+
+def test_short_reply_is_not_over_spaced(application: QApplication) -> None:
+    browser = ai_consult_module._RichMessage("ai")
+    browser.resize(660, 200)
+    browser.set_payload("血糖控制尚可，暂无需调整降糖方案。")
+    block = browser.document().begin()
+    assert block.blockFormat().topMargin() == 0
+    assert block.next().isValid() is False
+
+
+def test_sectioned_reply_becomes_a_structured_report(application: QApplication) -> None:
+    """The clinical panel only knows four fixed section names.
+
+    Real answers are sectioned as 症状演变 / 血糖控制 / 用药依从性 …, which matched
+    none of them and therefore fell back to a plain wall of text.
+    """
+
+    reply = (
+        "以下是针对该患者当前情况，建议向患者确认的关键问诊问题，用于补充现有病历中的信息缺口：\n\n"
+        "1. **症状演变与疗效评估**\n"
+        "   - **麻木症状：** 服药十四天后四肢麻木是否有所缓解？\n"
+        "   - **皮肤瘙痒：** 目前是否仍有发作？是否与血糖波动有关？\n"
+        "2. **血糖控制与监测细节**\n"
+        "   - **空腹血糖波动：** 近期是否有反复的低血糖发作？\n"
+        "3. **用药依从性与生活方式**\n"
+        "   - **西药服用情况：** 近期是否有漏服或自行调整剂量？\n\n"
+        "**提示：** 以上问题基于现有脱敏病例资料梳理，需由执业医师复核后确定。\n"
+    )
+    parsed = ai_consult_module.parse_structured_report(reply)
+    assert parsed is not None
+    intro, sections, disclaimer = parsed
+    assert [section.title for section in sections] == [
+        "症状演变与疗效评估",
+        "血糖控制与监测细节",
+        "用药依从性与生活方式",
+    ]
+    assert [len(section.items) for section in sections] == [2, 1, 1]
+    assert "信息缺口" in intro
+    assert "执业医师" in disclaimer
+
+    bubble = ai_consult_module._ChatBubble(role="ai", text=reply, time_text="千问 · 11:01")
+    assert bubble.finalize_clinical_analysis() is True
+    panel = bubble.findChild(ai_consult_module._StructuredReportPanel)
+    assert panel is not None
+    titles = [
+        label.text()
+        for label in panel.findChildren(QLabel)
+        if label.objectName() == "AiConsultClinicalSectionTitle"
+    ]
+    assert titles == ["症状演变与疗效评估", "血糖控制与监测细节", "用药依从性与生活方式"]
+    bubble.deleteLater()
+
+
+@pytest.mark.parametrize(
+    "reply",
+    [
+        "血糖控制尚可，暂无需调整降糖方案。",
+        "1. **只有一个小节**\n   - 一条要点\n",
+        '{"summary": "结构化 JSON 走既有解析路径"}',
+    ],
+)
+def test_unsectioned_replies_stay_plain_text(reply: str, application: QApplication) -> None:
+    assert ai_consult_module.parse_structured_report(reply) is None
@@ -7,7 +7,7 @@ from typing import Any
 os.environ.setdefault("QT_QPA_PLATFORM", "offscreen")

 import pytest
-from PySide6.QtWidgets import QApplication, QLabel
+from PySide6.QtWidgets import QApplication, QLabel, QTextBrowser

 from doctor_workstation.core import PermissionSet
 from doctor_workstation.core.errors import ApiTimeoutError
@@ -385,7 +385,10 @@ def test_diagnosis_assistant_calls_repository_with_exact_safe_payload(
            task: str,
        ) -> dict[str, Any]:
            calls.append({"diagnosis_id": diagnosis_id, "prompt": prompt, "task": task})
-            return {"answer": "建议复核肾功能与眼底。", "model_key": "openai"}
+            return {
+                "answer": "### 核心建议\n\n**重点复核**\n\n- 肾功能\n- 眼底",
+                "model_key": "openai",
+            }

    dialog = DiagnosisAiAssistantDialog(Repository())
    dialog.open_for(501, "并发症筛查", task="complication_risk")
@@ -393,15 +396,57 @@ def test_diagnosis_assistant_calls_repository_with_exact_safe_payload(
    assert calls == [
        {"diagnosis_id": 501, "prompt": "并发症筛查", "task": "complication_risk"}
    ]
-    assert dialog.answer_label.text() == "建议复核肾功能与眼底。"
+    assert dialog.answer_label.toPlainText() == "核心建议\n重点复核\n肾功能\n眼底"
+    assert "###" not in dialog.answer_label.toPlainText()
+    assert "**" not in dialog.answer_label.toPlainText()
+    rendered_html = dialog.answer_label.toHtml().lower()
+    assert "<h3" in rendered_html
+    assert "font-weight:700" in rendered_html.replace(" ", "")
    assert "openai" in dialog.model_label.text()
-    assert dialog.answer_scroll.widget().findChild(QLabel, "PrescriptionAiBody") is dialog.answer_label
+    assert isinstance(dialog.answer_label, QTextBrowser)
+    assert dialog.answer_label.objectName() == "PrescriptionAiAnswer"
+    assert dialog.answer_label.openLinks() is False
+    assert dialog.answer_label.openExternalLinks() is False
    assert dialog.loading is False
    assert dialog.retry_button.isEnabled()
    dialog.close()
    application.processEvents()


+def test_diagnosis_assistant_markdown_disables_model_supplied_html(
+    application: QApplication,
+    immediate_async: None,
+) -> None:
+    class Repository:
+        def analyze_diagnosis_ai(self, *args: Any, **kwargs: Any) -> dict[str, Any]:
+            return {
+                "answer": "### 安全内容\n\n<img src=\"https://invalid.example/pixel\">\n\n- 建议复诊",
+                "model_key": "qwen",
+            }
+
+    dialog = DiagnosisAiAssistantDialog(Repository())
+    dialog.open_for(501, "复诊建议", task="custom")
+
+    assert "安全内容" in dialog.answer_label.toPlainText()
+    assert "建议复诊" in dialog.answer_label.toPlainText()
+    assert "<img" in dialog.answer_label.toPlainText()
+    assert 'src="https://invalid.example/pixel"' not in dialog.answer_label.toHtml()
+    assert (
+        dialog.answer_label.loadResource(
+            ai_module.QTextDocument.ResourceType.ImageResource,
+            "https://invalid.example/pixel",
+        )
+        is None
+    )
+    dialog.answer_label.selectAll()
+    copied = dialog.answer_label.createMimeDataFromSelection()
+    assert copied.hasText()
+    assert copied.hasHtml() is False
+    assert set(copied.formats()) == {"text/plain"}
+    dialog.close()
+    application.processEvents()
+
+
 def test_diagnosis_assistant_timeout_is_visible_and_retryable(
    application: QApplication,
    immediate_async: None,
@@ -288,6 +288,82 @@ def test_shell_ai_entry_always_opens_patient_picker_even_with_current_selection(
    assert shell_window.stack.currentWidget() is current


+def test_shell_global_diagnosis_entry_reuses_dialog_and_obeys_permissions(
+    shell_window: ShellWindow,
+    monkeypatch: pytest.MonkeyPatch,
+) -> None:
+    opened: list[tuple[str, int]] = []
+    refresh_callbacks: list[Any] = []
+    created: list[Any] = []
+
+    class _SavedSignal:
+        def connect(self, callback: Any) -> None:
+            refresh_callbacks.append(callback)
+
+    class _DiagnosisDialogDouble:
+        def __init__(
+            self,
+            repository: Any,
+            parent: Any,
+            *,
+            permissions: Any,
+        ) -> None:
+            self.repository = repository
+            self.parent = parent
+            self.permissions = permissions
+            self.saved = _SavedSignal()
+            self.raise_count = 0
+            self.activate_count = 0
+            created.append(self)
+
+        def refresh_permissions(self, permissions: Any) -> None:
+            self.permissions = permissions
+
+        def open_for(
+            self,
+            diagnosis_id: int,
+            *,
+            editable: bool,
+            modeless: bool,
+        ) -> None:
+            assert editable is True
+            assert modeless is True
+            opened.append(("edit", diagnosis_id))
+
+        def open_view_only(self, diagnosis_id: int, *, modeless: bool) -> None:
+            assert modeless is True
+            opened.append(("view", diagnosis_id))
+
+        def raise_(self) -> None:
+            self.raise_count += 1
+
+        def activateWindow(self) -> None:  # noqa: N802 - Qt-compatible test double
+            self.activate_count += 1
+
+    monkeypatch.setattr(shell_module, "DiagnosisDialog", _DiagnosisDialogDouble)
+    shell_window._global_diagnosis_dialog = None
+
+    shell_window.permissions = {"tcm.diagnosis/edit"}
+    assert shell_window.open_diagnosis_by_id(501, modeless=True) is created[0]
+    shell_window.permissions = {"tcm.diagnosis/readonlyDetail"}
+    assert shell_window.open_diagnosis_by_id("502", modeless=True) is created[0]
+    shell_window.permissions = {"tcm.diagnosis/*"}
+    assert shell_window.open_diagnosis_by_id(503, modeless=True) is created[0]
+
+    assert opened == [("edit", 501), ("view", 502), ("edit", 503)]
+    assert len(created) == 1
+    assert created[0].parent is shell_window
+    assert len(refresh_callbacks) == 1
+    assert created[0].raise_count == 3
+    assert created[0].activate_count == 3
+
+    shell_window.permissions = set()
+    assert shell_window.open_diagnosis_by_id(504, modeless=True) is None
+    assert shell_window.open_diagnosis_by_id(0, modeless=True) is None
+    assert shell_window.open_diagnosis_by_id("invalid", modeless=True) is None
+    assert opened == [("edit", 501), ("view", 502), ("edit", 503)]
+
+
 def test_shell_ai_entry_without_selection_opens_patient_diagnosis_picker(
    application: QApplication,
    shell_window: ShellWindow,
@@ -95,7 +95,13 @@ def test_navigation_requires_each_pages_actual_list_capability() -> None:
 def test_video_release_does_not_remove_a_newer_call() -> None:
    older = object()
    newer = object()
-    controller = SimpleNamespace(video_calls={"501": newer})
+    # _release_video_call also clears the preview slot, so the double needs the
+    # same attributes the real controller sets up in __init__.
+    controller = SimpleNamespace(
+        video_calls={"501": newer},
+        _video_preview_state=None,
+        _video_preview_generation=0,
+    )

    ApplicationController._release_video_call(controller, "501", older)
    assert controller.video_calls == {"501": newer}
@@ -505,3 +511,37 @@ def test_certificate_error_opens_server_settings(tmp_path: Any) -> None:
    assert "信任自签名证书" in window.error_banner.label.text()
    window.close()
    application.processEvents()
+
+
+def test_business_dialogs_can_be_maximized_but_prompts_cannot() -> None:
+    """Dense AI panels and editors were stuck at their constructed size."""
+
+    from PySide6.QtCore import Qt
+    from PySide6.QtWidgets import QApplication, QDialog, QMessageBox
+
+    from doctor_workstation.ui.theme import allow_dialog_resize
+
+    application = QApplication.instance() or QApplication([])
+    assert application is not None
+
+    dialog = QDialog()
+    dialog.resize(600, 400)
+    allow_dialog_resize(dialog)
+    flags = dialog.windowFlags()
+    assert flags & Qt.WindowType.WindowMaximizeButtonHint
+    assert flags & Qt.WindowType.WindowMinimizeButtonHint
+    assert dialog.isSizeGripEnabled()
+    dialog.deleteLater()
+
+    # Transient prompts keep their plain frame.
+    prompt = QMessageBox()
+    allow_dialog_resize(prompt)
+    assert not (prompt.windowFlags() & Qt.WindowType.WindowMaximizeButtonHint)
+    prompt.deleteLater()
+
+    # A dialog that pinned itself to a fixed size keeps that decision.
+    fixed = QDialog()
+    fixed.setFixedSize(420, 300)
+    allow_dialog_resize(fixed)
+    assert not (fixed.windowFlags() & Qt.WindowType.WindowMaximizeButtonHint)
+    fixed.deleteLater()
@@ -5,7 +5,8 @@ import sys
 import threading
 import time
 from pathlib import Path
-from types import SimpleNamespace
+from types import MethodType, SimpleNamespace
+from typing import Any

 import pytest

@@ -52,7 +53,7 @@ def test_companion_archives_cloud_video_local_mixed_audio_and_transcript() -> No

    assert "context.createMediaStreamDestination()" in source
    assert "cloud.getAudioTrack({ processed: true })" in source
-    assert "userId: activeConfig.targetUserId" in source
+    assert "attachPatientAudioTrack(cloud, activeConfig.targetUserId)" in source
    assert "new MediaRecorder(destination.stream" in source
    assert "recorder.start(1000)" in source
    assert "bridge.startLocalAudioRecording(sessionId, mimeType)" in source
@@ -134,6 +135,12 @@ def test_companion_local_recording_waits_for_real_audio_and_has_runtime_fallback
    assert "stream.getAudioTracks()" in source
    assert "navigator.mediaDevices.getUserMedia" in source
    assert "await waitForCallAudioTracks(cloud, sessionId)" in source
+    assert "if (!attached)" in source
+    assert "cloud.getAudioTrack(userId)" in source
+    assert "event.sourceTrack" in source
+    assert "cloud.on('remote-audio-available'" in source
+    assert "localAudioCloud.off('remote-audio-available'" in source
+    assert "!event.userId || event.userId === activeConfig?.userID" in source
    assert "localRecordingAttachedSourceCount <= 0" in source
    assert "localRecordingBytes < 1024" in source
    assert "已阻止上传空文件" in source
@@ -201,6 +208,360 @@ def test_companion_shows_incremental_subtitles_but_only_persists_final_segments(
    assert "caption.text" in component_source


+def test_companion_keeps_transcript_and_patient_case_visible_in_a_side_rail() -> None:
+    companion_root = PROJECT_ROOT / "video_companion" / "src"
+    main_source = (companion_root / "main.ts").read_text(encoding="utf-8")
+    component_source = (companion_root / "App.vue").read_text(encoding="utf-8")
+    styles = (companion_root / "style.css").read_text(encoding="utf-8")
+    window_source = (
+        PROJECT_ROOT / "src" / "doctor_workstation" / "video" / "window.py"
+    ).read_text(encoding="utf-8")
+
+    assert "liveCaptions.value = [...previous, caption].slice(-120)" in main_source
+    assert "liveCaptionClearTimer" not in main_source
+    assert 'aria-label="患者病例与实时对话"' in component_source
+    assert 'id="patient-case-title"' in component_source
+    assert 'id="live-transcript-title"' in component_source
+    assert 'aria-label="打开完整诊单"' in component_source
+    assert "runAction(onOpenDiagnosis)" in component_source
+    assert "detail.clinicalDiagnosis" in component_source
+    assert 'v-for="field in caseFields"' in component_source
+    assert "{{ field.value }}" in component_source
+    assert "{{ caption.time }}" in component_source
+    assert "'caption-entry--partial': !caption.completed" in component_source
+    assert ':allowed-full-screen="false"' in component_source
+    assert ".video-layer--with-rail" in styles
+    assert ".consultation-rail" in styles
+    assert '"patientCase": self.patient_case' in window_source
+    assert 'event == "open-diagnosis-request"' in window_source
+    assert "QTimer.singleShot(0, self._open_diagnosis_safely)" in window_source
+    stop_source = main_source.split("async function stopTranscription", 1)[1].split(
+        "function transcriptionResult", 1
+    )[0]
+    assert "clearLiveCaptions()" not in stop_source
+
+
+def test_video_diagnosis_entry_uses_existing_permission_scoped_drawer() -> None:
+    app_source = (
+        PROJECT_ROOT / "src" / "doctor_workstation" / "app.py"
+    ).read_text(encoding="utf-8")
+    launcher_source = (
+        PROJECT_ROOT / "src" / "doctor_workstation" / "video" / "launcher.py"
+    ).read_text(encoding="utf-8")
+    main_source = (
+        PROJECT_ROOT / "video_companion" / "src" / "main.ts"
+    ).read_text(encoding="utf-8")
+    shell_source = (
+        PROJECT_ROOT / "src" / "doctor_workstation" / "ui" / "shell.py"
+    ).read_text(encoding="utf-8")
+    diagnosis_source = (
+        PROJECT_ROOT / "src" / "doctor_workstation" / "ui" / "dialogs" / "diagnosis.py"
+    ).read_text(encoding="utf-8")
+    styles = (
+        PROJECT_ROOT / "video_companion" / "src" / "style.css"
+    ).read_text(encoding="utf-8")
+
+    assert "shell.open_diagnosis_by_id(diagnosis_id, modeless=True)" in app_source
+    assert "self._show_video_preview(video_window, dialog)" in app_source
+    assert "WindowStaysOnTopHint" in app_source
+    assert "dialog.finished.connect" in app_source
+    assert "modeless=modeless" in shell_source
+    assert "not modeless and not self._standalone_readonly" in diagnosis_source
+    compact_styles = styles.split("@media (max-width: 700px)", 1)[1]
+    assert ".consultation-rail { display: none; }" in compact_styles
+    assert ".capture-button { display: none; }" in compact_styles
+    assert "on_open_diagnosis=on_open_diagnosis" in launcher_source
+    assert "event: 'open-diagnosis-request'" in main_source
+
+
+def test_video_preview_is_compact_and_restores_after_diagnosis_closes() -> None:
+    from PySide6.QtCore import Qt
+
+    from doctor_workstation.app import ApplicationController
+
+    class _Rect:
+        def x(self) -> int:
+            return 0
+
+        def y(self) -> int:
+            return 0
+
+        def width(self) -> int:
+            return 1920
+
+        def height(self) -> int:
+            return 1040
+
+    class _Screen:
+        def availableGeometry(self) -> _Rect:  # noqa: N802 - Qt-compatible double
+            return _Rect()
+
+    class _Window:
+        def __init__(self) -> None:
+            self.original_geometry = object()
+            self.original_minimum = object()
+            self.minimum = self.original_minimum
+            self.geometry_value = self.original_geometry
+            self.size = (900, 600)
+            self.position = (30, 40)
+            self.stays_on_top = False
+            self.activated = 0
+
+        def geometry(self) -> object:
+            return self.geometry_value
+
+        def minimumSize(self) -> object:  # noqa: N802 - Qt-compatible double
+            return self.minimum
+
+        def isMaximized(self) -> bool:  # noqa: N802 - Qt-compatible double
+            return False
+
+        def isFullScreen(self) -> bool:  # noqa: N802 - Qt-compatible double
+            return False
+
+        def windowFlags(self) -> Qt.WindowType:  # noqa: N802 - Qt-compatible double
+            return Qt.WindowType.Window
+
+        def screen(self) -> _Screen:
+            return _Screen()
+
+        def showNormal(self) -> None:  # noqa: N802 - Qt-compatible double
+            return None
+
+        def showMaximized(self) -> None:  # noqa: N802 - Qt-compatible double
+            return None
+
+        def showFullScreen(self) -> None:  # noqa: N802 - Qt-compatible double
+            return None
+
+        def setMinimumSize(self, *value: object) -> None:  # noqa: N802
+            self.minimum = value[0] if len(value) == 1 else value
+
+        def setWindowFlag(self, _flag: Any, enabled: bool) -> None:  # noqa: N802
+            self.stays_on_top = enabled
+
+        def resize(self, width: int, height: int) -> None:
+            self.size = (width, height)
+
+        def move(self, x: int, y: int) -> None:
+            self.position = (x, y)
+
+        def setGeometry(self, geometry: object) -> None:  # noqa: N802
+            self.geometry_value = geometry
+
+        def show(self) -> None:
+            return None
+
+        def raise_(self) -> None:
+            return None
+
+        def activateWindow(self) -> None:  # noqa: N802 - Qt-compatible double
+            self.activated += 1
+
+    class _Signal:
+        def __init__(self) -> None:
+            self.callbacks: list[Any] = []
+
+        def connect(self, callback: Any) -> None:
+            self.callbacks.append(callback)
+
+    class _Dialog:
+        def __init__(self) -> None:
+            self.finished = _Signal()
+
+        def raise_(self) -> None:
+            return None
+
+        def activateWindow(self) -> None:  # noqa: N802 - Qt-compatible double
+            return None
+
+    controller = SimpleNamespace(
+        _video_preview_state=None,
+        _video_preview_generation=0,
+    )
+    controller._restore_video_preview = MethodType(  # type: ignore[attr-defined]
+        ApplicationController._restore_video_preview,
+        controller,
+    )
+    window = _Window()
+    dialog = _Dialog()
+
+    ApplicationController._show_video_preview(controller, window, dialog)
+
+    assert window.minimum == (440, 300)
+    assert window.size == (540, 356)
+    assert window.position == (1362, 18)
+    assert window.stays_on_top is True
+    assert len(dialog.finished.callbacks) == 1
+
+    dialog.finished.callbacks[0](0)
+
+    assert window.minimum is window.original_minimum
+    assert window.geometry_value is window.original_geometry
+    assert window.stays_on_top is False
+    assert window.activated == 1
+
+
+def test_video_patient_case_snapshot_is_bounded_and_clinically_useful() -> None:
+    from doctor_workstation.app import _build_video_patient_case
+
+    summary = _build_video_patient_case(
+        {
+            "diagnosis": {
+                "patient_name": "张三",
+                "id": 8279,
+                "source_patient_id": 42,
+                "gender": 1,
+                "age": 47,
+                "chief_complaint": "反复口渴三个月",
+                "present_illness": "近期空腹血糖偏高",
+                "allergy_history": "青霉素",
+                "current_medicine": ["二甲双胍", "阿卡波糖"],
+                "clinical_diagnosis": "2 型糖尿病",
+            },
+            "appointment": {"appointment_date": "2026-08-26"},
+            "internal_audit": {"token": "must-not-cross-the-bridge"},
+        },
+        {},
+        diagnosis_id=8279,
+        patient_id=42,
+        patient_name="患者",
+    )
+
+    assert summary["diagnosisId"] == "8279"
+    assert summary["name"] == "张三"
+    assert summary["gender"] == "男"
+    assert summary["age"] == "47"
+    assert summary["chiefComplaint"] == "反复口渴三个月"
+    assert summary["currentMedication"] == "二甲双胍、阿卡波糖"
+    assert summary["allergyHistory"] == "青霉素"
+    assert "internal_audit" not in summary
+    assert set(summary) == {
+        "diagnosisId",
+        "name",
+        "gender",
+        "age",
+        "height",
+        "weight",
+        "diagnosisDate",
+        "appointmentDate",
+        "clinicalDiagnosis",
+        "chiefComplaint",
+        "presentIllness",
+        "pastHistory",
+        "allergyHistory",
+        "personalHistory",
+        "familyHistory",
+        "currentMedication",
+        "tongue",
+        "pulse",
+        "prescriptionOpinion",
+        "remark",
+    }
+
+    bounded = _build_video_patient_case(
+        {},
+        {
+            "diagnosis_id": 8279,
+            "patient_id": 42,
+            "patient_name": "患" * 180,
+            "age": "4" * 40,
+            "remark": "病" * 2400,
+        },
+        diagnosis_id=8279,
+        patient_id=42,
+        patient_name="患者",
+    )
+    assert len(bounded["name"]) == 120
+    assert len(bounded["age"]) == 20
+    assert len(bounded["remark"]) == 2000
+
+
+@pytest.mark.parametrize(
+    "detail",
+    [
+        {
+            "id": 8279,
+            "source_patient_id": 42,
+            "patient_name": "张三",
+            "chief_complaint": "口渴",
+        },
+        {
+            "data": {
+                "id": 8279,
+                "source_patient_id": 42,
+                "patient_name": "张三",
+                "chief_complaint": "口渴",
+            }
+        },
+        {
+            "diagnosis": {
+                "id": 8279,
+                "source_patient_id": 42,
+                "patient_name": "张三",
+                "chief_complaint": "口渴",
+            }
+        },
+    ],
+)
+def test_video_patient_case_accepts_supported_readonly_detail_shapes(detail: object) -> None:
+    from doctor_workstation.app import _build_video_patient_case
+
+    summary = _build_video_patient_case(
+        detail,
+        {},
+        diagnosis_id=8279,
+        patient_id=42,
+        patient_name="患者",
+    )
+
+    assert summary["name"] == "张三"
+    assert summary["chiefComplaint"] == "口渴"
+
+
+def test_video_patient_case_fails_closed_on_identity_mismatch() -> None:
+    from doctor_workstation.app import _build_video_patient_case
+
+    summary = _build_video_patient_case(
+        {
+            "diagnosis": {
+                "id": 9001,
+                "source_patient_id": 7,
+                "patient_name": "其他患者",
+                "chief_complaint": "不得展示",
+                "allergy_history": "不得展示",
+            }
+        },
+        {
+            "diagnosis_id": 9001,
+            "patient_id": 7,
+            "chief_complaint": "也不得展示",
+        },
+        diagnosis_id=8279,
+        patient_id=42,
+        patient_name="张三",
+    )
+
+    assert summary["name"] == "张三"
+    assert summary["chiefComplaint"] == ""
+    assert summary["allergyHistory"] == ""
+
+
+def test_built_video_companion_contains_the_patient_case_rail() -> None:
+    dist_root = PROJECT_ROOT / "video_companion" / "dist"
+    styles = "\n".join(
+        path.read_text(encoding="utf-8") for path in (dist_root / "assets").glob("*.css")
+    )
+    scripts = "\n".join(
+        path.read_text(encoding="utf-8") for path in (dist_root / "assets").glob("*.js")
+    )
+
+    assert ".consultation-rail" in styles
+    assert ".video-layer--with-rail" in styles
+    assert "patientCase" in scripts
+    assert "患者病例与实时对话" in scripts
+
+
 def test_companion_screenshot_requires_doctor_confirmation_before_upload() -> None:
    source = (PROJECT_ROOT / "video_companion" / "src" / "App.vue").read_text(
        encoding="utf-8"
@@ -6,8 +6,8 @@
    <meta name="color-scheme" content="light" />
    <link rel="icon" type="image/png" href="./favicon.png" />
    <title>视频面诊</title>
-    <script type="module" crossorigin src="./assets/index-DhmAWjut.js"></script>
-    <link rel="stylesheet" crossorigin href="./assets/index-BsDbRyxy.css">
+    <script type="module" crossorigin src="./assets/index-B_ek5NUi.js"></script>
+    <link rel="stylesheet" crossorigin href="./assets/index-BMSk91Wa.css">
  </head>
  <body>
    <div id="app"></div>
@@ -18,9 +18,39 @@ interface LiveCaption {
  id: string
  speaker: string
  text: string
+  time: string
  completed: boolean
 }

+interface PatientCase {
+  diagnosisId: string
+  name: string
+  gender: string
+  age: string
+  height: string
+  weight: string
+  diagnosisDate: string
+  appointmentDate: string
+  clinicalDiagnosis: string
+  chiefComplaint: string
+  presentIllness: string
+  pastHistory: string
+  allergyHistory: string
+  personalHistory: string
+  familyHistory: string
+  currentMedication: string
+  tongue: string
+  pulse: string
+  prescriptionOpinion: string
+  remark: string
+}
+
+interface CaseField {
+  label: string
+  value: string
+  risk?: boolean
+}
+
 const props = defineProps<{
  phase: Readonly<Ref<string>>
  statusText: Readonly<Ref<string>>
@@ -34,12 +64,14 @@ const props = defineProps<{
  transcriptionState: Readonly<Ref<string>>
  localRecordingState: Readonly<Ref<string>>
  liveCaptions: Readonly<Ref<LiveCaption[]>>
+  patientCase: Readonly<Ref<PatientCase>>
  onSendText: (text: string) => Promise<void>
  onSendAttachment: (file: File) => Promise<void>
  onLoadMore: () => Promise<void>
  onReconnectChat: () => Promise<void>
  onStartVideo: () => Promise<void>
  onHangup: () => Promise<void>
+  onOpenDiagnosis: () => Promise<void>
  onSaveScreenshot: (dataUrl: string) => Promise<void>
 }>()

@@ -50,6 +82,7 @@ const messageList = ref<HTMLElement | null>(null)
 const fileInput = ref<HTMLInputElement | null>(null)
 const screenshotPreview = ref('')
 const stickToMessageBottom = ref(true)
+const transcriptList = ref<HTMLElement | null>(null)

 const isChat = computed(() => props.mode.value === 'chat')
 const isCalling = computed(() => ['starting', 'dialing', 'connected'].includes(props.phase.value))
@@ -84,6 +117,41 @@ const transcriptionStatusText = computed(() => {
  if (textState === 'error') return '实时转写失败，本机录音仍在运行'
  return '录音与转写已结束'
 })
+const patientMetaText = computed(() => {
+  const detail = props.patientCase.value
+  return [
+    detail.gender,
+    detail.age ? `${detail.age}岁` : '',
+    detail.height ? `${detail.height} cm` : '',
+    detail.weight ? `${detail.weight} kg` : '',
+  ].filter(Boolean).join(' · ') || '基础资料待补充'
+})
+const patientVisitText = computed(() => {
+  const detail = props.patientCase.value
+  if (detail.appointmentDate) return `预约 ${detail.appointmentDate}`
+  if (detail.diagnosisDate) return `诊断 ${detail.diagnosisDate}`
+  return `诊单 ${detail.diagnosisId || '—'}`
+})
+const caseFields = computed<CaseField[]>(() => {
+  const detail = props.patientCase.value
+  const allergyRisk = Boolean(detail.allergyHistory) && !/^(无|否|未发现|无过敏史|none|no)$/i.test(
+    detail.allergyHistory.trim(),
+  )
+  return [
+    { label: '临床诊断', value: detail.clinicalDiagnosis },
+    { label: '主诉', value: detail.chiefComplaint },
+    { label: '现病史', value: detail.presentIllness },
+    { label: '当前用药', value: detail.currentMedication },
+    { label: '过敏史', value: detail.allergyHistory, risk: allergyRisk },
+    { label: '既往史', value: detail.pastHistory },
+    { label: '个人史', value: detail.personalHistory },
+    { label: '家族史', value: detail.familyHistory },
+    { label: '舌象', value: detail.tongue },
+    { label: '脉象', value: detail.pulse },
+    { label: '处方意见', value: detail.prescriptionOpinion },
+    { label: '病例备注', value: detail.remark },
+  ].filter((item) => Boolean(item.value))
+})

 watch(
  () => props.messages.value.length,
@@ -103,6 +171,17 @@ watch(
  },
 )

+watch(
+  () => {
+    const last = props.liveCaptions.value.at(-1)
+    return `${props.liveCaptions.value.length}:${last?.id || ''}:${last?.text || ''}`
+  },
+  async () => {
+    await nextTick()
+    if (transcriptList.value) transcriptList.value.scrollTop = transcriptList.value.scrollHeight
+  },
+)
+
 function handleMessageScroll(): void {
  const container = messageList.value
  if (!container) return
@@ -335,70 +414,154 @@ watch(
      </footer>
    </section>

-    <section v-if="videoVisible" class="video-layer" :class="{ 'video-layer--overlay': isChat }">
-      <TUICallKit
-        class="call-kit"
-        :allowed-minimized="false"
-        :allowed-full-screen="true"
-      />
+    <section
+      v-if="videoVisible"
+      class="video-layer"
+      :class="{
+        'video-layer--overlay': isChat,
+        'video-layer--with-rail': isCalling,
+      }"
+    >
+      <div class="video-stage">
+        <TUICallKit
+          class="call-kit"
+          :allowed-minimized="false"
+          :allowed-full-screen="false"
+        />

-      <section v-if="phase.value === 'ready' || phase.value === 'starting' || phase.value === 'error'" class="status-card">
-        <span class="status-dot" :class="`status-dot--${phase.value}`" aria-hidden="true" />
-        <div>
-          <p class="eyebrow">中医视频问诊</p>
-          <h2>{{ statusText.value }}</h2>
-          <p class="status-hint">视频通话凭证仅由业务服务器签发</p>
+        <section v-if="phase.value === 'ready' || phase.value === 'starting' || phase.value === 'error'" class="status-card">
+          <span class="status-dot" :class="`status-dot--${phase.value}`" aria-hidden="true" />
+          <div>
+            <p class="eyebrow">中医视频问诊</p>
+            <h2>{{ statusText.value }}</h2>
+            <p class="status-hint">视频通话凭证仅由业务服务器签发</p>
+          </div>
+        </section>
+
+        <div v-else class="live-status" role="status">
+          <span class="status-dot status-dot--live" aria-hidden="true" />
+          {{ statusText.value }}
        </div>
-      </section>

-      <div v-else class="live-status" role="status">
-        <span class="status-dot status-dot--live" aria-hidden="true" />
-        {{ statusText.value }}
-      </div>
+        <div v-if="isCalling" class="video-actions">
+          <div
+            v-if="canCapture"
+            class="recording-status"
+            :class="{
+              'recording-status--active': transcriptionActive,
+              'recording-status--error': transcriptionFailed,
+            }"
+            role="status"
+            aria-live="polite"
+          >
+            <span class="recording-indicator" aria-hidden="true" />
+            {{ transcriptionStatusText }}
+          </div>
+          <button
+            class="capture-button"
+            type="button"
+            :disabled="!canCapture || actionBusy"
+            @click="captureScreenshot"
+          >
+            截屏预览
+          </button>
+          <button class="hangup-button" type="button" :disabled="actionBusy" @click="runAction(onHangup)">
+            结束视频
+          </button>
+        </div>

-      <div
-        v-if="canCapture && liveCaptions.value.length"
-        class="live-captions"
-        role="log"
-        aria-live="polite"
-        aria-label="实时语音字幕"
-      >
-        <p v-for="caption in liveCaptions.value" :key="caption.id">
-          <strong>{{ caption.speaker }}</strong>
-          <span>{{ caption.text }}</span>
-        </p>
-      </div>
-
-      <div v-if="isCalling" class="video-actions">
-        <div
-          v-if="canCapture"
-          class="recording-status"
-          :class="{
-            'recording-status--active': transcriptionActive,
-            'recording-status--error': transcriptionFailed,
-          }"
-          role="status"
-          aria-live="polite"
-        >
-          <span class="recording-indicator" aria-hidden="true" />
-          {{ transcriptionStatusText }}
+        <div v-if="localError || notice.value" class="video-notice" :class="{ 'video-notice--error': localError }">
+          {{ localError || notice.value }}
        </div>
-        <button
-          class="capture-button"
-          type="button"
-          :disabled="!canCapture || actionBusy"
-          @click="captureScreenshot"
-        >
-          截屏预览
-        </button>
-        <button class="hangup-button" type="button" :disabled="actionBusy" @click="runAction(onHangup)">
-          结束视频
-        </button>
      </div>

-      <div v-if="localError || notice.value" class="video-notice" :class="{ 'video-notice--error': localError }">
-        {{ localError || notice.value }}
-      </div>
+      <aside v-if="isCalling" class="consultation-rail" aria-label="患者病例与实时对话">
+        <header class="consultation-rail__header">
+          <div class="consultation-rail__avatar" aria-hidden="true">
+            {{ (patientCase.value.name || patientName.value).slice(0, 1) }}
+          </div>
+          <div class="consultation-rail__identity">
+            <strong>{{ patientCase.value.name || patientName.value }}</strong>
+            <span>{{ patientMetaText }}</span>
+          </div>
+          <div class="consultation-rail__actions">
+            <span class="diagnosis-chip">诊单 {{ patientCase.value.diagnosisId || '—' }}</span>
+            <button
+              class="open-diagnosis-button"
+              type="button"
+              :disabled="actionBusy"
+              aria-label="打开完整诊单"
+              @click="runAction(onOpenDiagnosis)"
+            >
+              打开诊单
+              <span aria-hidden="true">↗</span>
+            </button>
+          </div>
+        </header>
+
+        <section class="case-panel" aria-labelledby="patient-case-title">
+          <header class="rail-section-heading">
+            <div>
+              <span class="rail-section-heading__index">01</span>
+              <h2 id="patient-case-title">患者病例</h2>
+            </div>
+            <span>{{ patientVisitText }}</span>
+          </header>
+          <div class="case-panel__content">
+            <div v-if="caseFields.length" class="case-field-list">
+              <article
+                v-for="field in caseFields"
+                :key="field.label"
+                class="case-field"
+                :class="{ 'case-field--risk': field.risk }"
+              >
+                <span>{{ field.label }}</span>
+                <p>{{ field.value }}</p>
+              </article>
+            </div>
+            <div v-else class="rail-empty rail-empty--case">
+              <strong>暂无已填写的病例内容</strong>
+              <span>可继续通话，已补充的病例会在下次打开时显示。</span>
+            </div>
+          </div>
+        </section>
+
+        <section class="transcript-panel" aria-labelledby="live-transcript-title">
+          <header class="rail-section-heading">
+            <div>
+              <span class="rail-section-heading__index">02</span>
+              <h2 id="live-transcript-title">实时对话</h2>
+            </div>
+            <span class="transcript-state" :class="{ 'transcript-state--active': transcriptionActive }">
+              {{ transcriptionActive ? '转写中' : '等待语音' }}
+            </span>
+          </header>
+          <div
+            ref="transcriptList"
+            class="live-captions"
+            role="log"
+            aria-live="polite"
+            aria-label="实时语音字幕"
+          >
+            <div v-if="!liveCaptions.value.length" class="rail-empty">
+              <strong>对话文字会显示在这里</strong>
+              <span>接通后自动识别医生与患者语音，并保留本次通话内容。</span>
+            </div>
+            <article
+              v-for="caption in liveCaptions.value"
+              :key="caption.id"
+              class="caption-entry"
+              :class="{ 'caption-entry--partial': !caption.completed }"
+            >
+              <header>
+                <strong>{{ caption.speaker }}</strong>
+                <time>{{ caption.time }}</time>
+              </header>
+              <p>{{ caption.text }}</p>
+            </article>
+          </div>
+        </section>
+      </aside>

      <div
        v-if="screenshotPreview"
@@ -15,9 +15,33 @@ interface DoctorCallConfig {
  patientUserId?: string
  diagnosisId: number | string
  patientName?: string
+  patientCase?: DoctorPatientCase
  mode?: 'chat' | 'video'
 }

+interface DoctorPatientCase {
+  diagnosisId?: number | string
+  name?: string
+  gender?: string
+  age?: string | number
+  height?: string | number
+  weight?: string | number
+  diagnosisDate?: string
+  appointmentDate?: string
+  clinicalDiagnosis?: string
+  chiefComplaint?: string
+  presentIllness?: string
+  pastHistory?: string
+  allergyHistory?: string
+  personalHistory?: string
+  familyHistory?: string
+  currentMedication?: string
+  tongue?: string
+  pulse?: string
+  prescriptionOpinion?: string
+  remark?: string
+}
+
 interface DoctorCallApi {
  start(config: DoctorCallConfig): Promise<void>
  hangup(): Promise<void>
@@ -26,6 +26,7 @@ interface NormalizedCallConfig {
  targetUserId: string
  diagnosisId: number | string
  patientName: string
+  patientCase: UiPatientCase
  mode: CompanionMode
 }

@@ -44,9 +45,33 @@ interface UiLiveCaption {
  id: string
  speaker: string
  text: string
+  time: string
  completed: boolean
 }

+interface UiPatientCase {
+  diagnosisId: string
+  name: string
+  gender: string
+  age: string
+  height: string
+  weight: string
+  diagnosisDate: string
+  appointmentDate: string
+  clinicalDiagnosis: string
+  chiefComplaint: string
+  presentIllness: string
+  pastHistory: string
+  allergyHistory: string
+  personalHistory: string
+  familyHistory: string
+  currentMedication: string
+  tongue: string
+  pulse: string
+  prescriptionOpinion: string
+  remark: string
+}
+
 interface BridgeMessage {
  source: 'doctor-call'
  event:
@@ -56,6 +81,7 @@ interface BridgeMessage {
    | 'room'
    | 'hangup'
    | 'error'
+    | 'open-diagnosis-request'
    | 'transcription-start-request'
    | 'transcription-segment'
    | 'transcription-stop'
@@ -127,6 +153,11 @@ interface PendingLocalRecordingReply {
 interface TrtcAudioTrackEvent {
  userId?: string
  track?: MediaStreamTrack
+  sourceTrack?: MediaStreamTrack
+}
+
+interface TrtcRemoteAudioEvent {
+  userId?: string
 }

 interface TrtcAudioCloud {
@@ -135,7 +166,9 @@ interface TrtcAudioCloud {
    processed?: boolean
  } | string): MediaStreamTrack | null
  on?(event: 'track', handler: (event: TrtcAudioTrackEvent) => void): void
+  on?(event: 'remote-audio-available', handler: (event: TrtcRemoteAudioEvent) => void): void
  off?(event: 'track', handler: (event: TrtcAudioTrackEvent) => void): void
+  off?(event: 'remote-audio-available', handler: (event: TrtcRemoteAudioEvent) => void): void
 }

 const phase = ref<CallPhase>('ready')
@@ -150,6 +183,7 @@ const hasMoreMessages = ref(false)
 const transcriptionState = ref<TranscriptionState>('idle')
 const localRecordingState = ref<LocalRecordingState>('idle')
 const liveCaptions = ref<UiLiveCaption[]>([])
+const patientCase = ref<UiPatientCase>(emptyPatientCase())

 let activeConfig: NormalizedCallConfig | null = null
 let chat: any = null
@@ -192,6 +226,7 @@ let localAudioContext: AudioContext | null = null
 let localAudioDestination: MediaStreamAudioDestinationNode | null = null
 let localAudioCloud: TrtcAudioCloud | null = null
 let localAudioTrackHandler: ((event: TrtcAudioTrackEvent) => void) | null = null
+let localRemoteAudioAvailableHandler: ((event: TrtcRemoteAudioEvent) => void) | null = null
 let localAudioSources: MediaStreamAudioSourceNode[] = []
 let localAudioTrackIds = new Set<string>()
 let localAudioOwnedTracks: MediaStreamTrack[] = []
@@ -205,8 +240,6 @@ let localRecordingChunkChain: Promise<void> = Promise.resolve()
 let localRecordingStartPromise: Promise<void> | null = null
 let localRecordingStopPromise: Promise<void> | null = null
 let localRecordingFatalError = ''
-let liveCaptionClearTimer: number | null = null
-
 function initializeQtWebChannel(): void {
  const transport = window.qt?.webChannelTransport
  const QWebChannel = window.QWebChannel
@@ -259,11 +292,80 @@ function emit(message: BridgeMessage): void {
  }
 }

+async function openDiagnosis(): Promise<void> {
+  if (!activeConfig) throw new Error('诊单上下文尚未就绪')
+  emit({
+    source: 'doctor-call',
+    event: 'open-diagnosis-request',
+    diagnosisId: activeConfig.diagnosisId,
+  })
+}
+
 function cleanString(value: unknown, field: string): string {
  if (typeof value !== 'string' || value.trim() === '') throw new Error(`${field}不能为空`)
  return value.trim()
 }

+function optionalText(value: unknown, maxLength = 2000): string {
+  if (value === undefined || value === null) return ''
+  return String(value).trim().slice(0, maxLength)
+}
+
+function emptyPatientCase(): UiPatientCase {
+  return {
+    diagnosisId: '',
+    name: '',
+    gender: '',
+    age: '',
+    height: '',
+    weight: '',
+    diagnosisDate: '',
+    appointmentDate: '',
+    clinicalDiagnosis: '',
+    chiefComplaint: '',
+    presentIllness: '',
+    pastHistory: '',
+    allergyHistory: '',
+    personalHistory: '',
+    familyHistory: '',
+    currentMedication: '',
+    tongue: '',
+    pulse: '',
+    prescriptionOpinion: '',
+    remark: '',
+  }
+}
+
+function normalizePatientCase(
+  value: DoctorPatientCase | undefined,
+  diagnosisId: number | string,
+  fallbackName: string,
+): UiPatientCase {
+  const source = value && typeof value === 'object' ? value : {}
+  return {
+    diagnosisId: optionalText(source.diagnosisId ?? diagnosisId, 80),
+    name: optionalText(source.name || fallbackName, 120) || fallbackName,
+    gender: optionalText(source.gender, 20),
+    age: optionalText(source.age, 20),
+    height: optionalText(source.height, 20),
+    weight: optionalText(source.weight, 20),
+    diagnosisDate: optionalText(source.diagnosisDate, 80),
+    appointmentDate: optionalText(source.appointmentDate, 80),
+    clinicalDiagnosis: optionalText(source.clinicalDiagnosis),
+    chiefComplaint: optionalText(source.chiefComplaint),
+    presentIllness: optionalText(source.presentIllness),
+    pastHistory: optionalText(source.pastHistory),
+    allergyHistory: optionalText(source.allergyHistory),
+    personalHistory: optionalText(source.personalHistory),
+    familyHistory: optionalText(source.familyHistory),
+    currentMedication: optionalText(source.currentMedication),
+    tongue: optionalText(source.tongue),
+    pulse: optionalText(source.pulse),
+    prescriptionOpinion: optionalText(source.prescriptionOpinion),
+    remark: optionalText(source.remark),
+  }
+}
+
 function normalizeConfig(config: DoctorCallConfig): NormalizedCallConfig {
  if (!config || typeof config !== 'object') throw new Error('问诊配置无效')
  const SDKAppID = Number(config.SDKAppID ?? config.sdkAppId)
@@ -274,15 +376,17 @@ function normalizeConfig(config: DoctorCallConfig): NormalizedCallConfig {
    throw new Error('诊单ID不能为空')
  }

+  const normalizedPatientName = typeof config.patientName === 'string' && config.patientName.trim()
+    ? config.patientName.trim()
+    : '患者'
  return {
    SDKAppID,
    userID: cleanString(config.userID ?? config.userId, '医生用户ID'),
    userSig: cleanString(config.userSig, '用户签名'),
    targetUserId: cleanString(config.targetUserId ?? config.patientUserId, '患者用户ID'),
    diagnosisId: typeof diagnosisId === 'string' ? diagnosisId.trim() : diagnosisId,
-    patientName: typeof config.patientName === 'string' && config.patientName.trim()
-      ? config.patientName.trim()
-      : '患者',
+    patientName: normalizedPatientName,
+    patientCase: normalizePatientCase(config.patientCase, diagnosisId, normalizedPatientName),
    mode: config.mode === 'chat' ? 'chat' : 'video',
  }
 }
@@ -747,30 +851,50 @@ function attachLocalRecordingTrack(
  return true
 }

+function attachDoctorAudioTrack(cloud: TrtcAudioCloud): boolean {
+  if (typeof cloud.getAudioTrack !== 'function') return false
+  let attached = false
+  try {
+    attached = attachLocalRecordingTrack(cloud.getAudioTrack({ processed: true }), 'doctor')
+  } catch {
+    // Some TRTC versions do not support processed tracks.
+  }
+  if (!attached) {
+    try {
+      attached = attachLocalRecordingTrack(cloud.getAudioTrack(), 'doctor')
+    } catch {
+      // The microphone fallback below remains available.
+    }
+  }
+  return attached
+}
+
+function attachPatientAudioTrack(cloud: TrtcAudioCloud, userId: string): boolean {
+  if (typeof cloud.getAudioTrack !== 'function' || !userId) return false
+  let attached = false
+  try {
+    attached = attachLocalRecordingTrack(cloud.getAudioTrack({
+      userId,
+      processed: true,
+    }), 'patient')
+  } catch {
+    // Some TRTC versions do not expose a processed remote track.
+  }
+  if (!attached) {
+    try {
+      attached = attachLocalRecordingTrack(cloud.getAudioTrack(userId), 'patient')
+    } catch {
+      // Remote audio can become available a few frames after connected.
+    }
+  }
+  return attached
+}
+
 function attachCurrentCallAudioTracks(cloud: TrtcAudioCloud | null): void {
  if (!activeConfig) return
-  if (typeof cloud?.getAudioTrack === 'function') {
-    try {
-      attachLocalRecordingTrack(cloud.getAudioTrack({ processed: true }), 'doctor')
-    } catch {
-      try {
-        attachLocalRecordingTrack(cloud.getAudioTrack(), 'doctor')
-      } catch {
-        // The rendered media elements below remain a supported fallback.
-      }
-    }
-    try {
-      attachLocalRecordingTrack(cloud.getAudioTrack({
-        userId: activeConfig.targetUserId,
-        processed: true,
-      }), 'patient')
-    } catch {
-      try {
-        attachLocalRecordingTrack(cloud.getAudioTrack(activeConfig.targetUserId), 'patient')
-      } catch {
-        // Remote audio can become available a few frames after connected.
-      }
-    }
+  if (cloud) {
+    attachDoctorAudioTrack(cloud)
+    attachPatientAudioTrack(cloud, activeConfig.targetUserId)
  }

  for (const media of document.querySelectorAll<HTMLMediaElement>('video, audio')) {
@@ -852,8 +976,20 @@ async function cleanupLocalRecordingGraph(): Promise<void> {
      // The call engine may already have released its event dispatcher.
    }
  }
+  if (
+    localAudioCloud
+    && localRemoteAudioAvailableHandler
+    && typeof localAudioCloud.off === 'function'
+  ) {
+    try {
+      localAudioCloud.off('remote-audio-available', localRemoteAudioAvailableHandler)
+    } catch {
+      // The call engine may already have released its event dispatcher.
+    }
+  }
  localAudioCloud = null
  localAudioTrackHandler = null
+  localRemoteAudioAvailableHandler = null
  for (const source of localAudioSources) {
    try {
      source.disconnect()
@@ -910,15 +1046,26 @@ async function performStartLocalRecording(): Promise<void> {
    localAudioDestination = context.createMediaStreamDestination()
    const cloud = getTrtcAudioCloud()
    localAudioCloud = cloud
-    localAudioTrackHandler = (event) => attachLocalRecordingTrack(
-      event.track,
-      event.userId === activeConfig?.userID
+    localAudioTrackHandler = (event) => {
+      const sourceKind = !event.userId || event.userId === activeConfig?.userID
        ? 'doctor'
        : event.userId === activeConfig?.targetUserId
          ? 'patient'
-          : 'unknown',
-    )
-    if (typeof cloud?.on === 'function') cloud.on('track', localAudioTrackHandler)
+          : 'unknown'
+      if (!attachLocalRecordingTrack(event.track, sourceKind)) {
+        attachLocalRecordingTrack(event.sourceTrack, sourceKind)
+      }
+    }
+    localRemoteAudioAvailableHandler = (event) => {
+      const userId = event.userId || activeConfig?.targetUserId || ''
+      if (cloud && userId === activeConfig?.targetUserId) {
+        attachPatientAudioTrack(cloud, userId)
+      }
+    }
+    if (typeof cloud?.on === 'function') {
+      cloud.on('track', localAudioTrackHandler)
+      cloud.on('remote-audio-available', localRemoteAudioAvailableHandler)
+    }
    if (context.state === 'suspended') await context.resume()
    await waitForCallAudioTracks(cloud, sessionId)
    startCallAudioDiscovery(cloud)
@@ -1151,10 +1298,6 @@ function getTranscriberManager(): RealtimeTranscriberManager {
 }

 function clearLiveCaptions(): void {
-  if (liveCaptionClearTimer !== null) {
-    window.clearTimeout(liveCaptionClearTimer)
-    liveCaptionClearTimer = null
-  }
  liveCaptions.value = []
 }

@@ -1170,19 +1313,26 @@ function showLiveCaption(message: RealtimeTranscriberMessage): void {
    : speakerUserId === activeConfig.targetUserId
      ? patientName.value || '患者'
      : '对话'
+  const rawTimestamp = Number(message.timestamp)
+  const captionTimestamp = Number.isFinite(rawTimestamp) && rawTimestamp > 0
+    ? (rawTimestamp < 1_000_000_000_000 ? rawTimestamp * 1000 : rawTimestamp)
+    : Date.now()
  const caption: UiLiveCaption = {
    id,
    speaker,
    text: text.slice(0, 500),
+    time: new Date(captionTimestamp).toLocaleTimeString('zh-CN', {
+      hour: '2-digit',
+      minute: '2-digit',
+      hour12: false,
+    }),
    completed: message.isCompleted === true,
  }
  const previous = liveCaptions.value.filter((item) => item.id !== id)
-  liveCaptions.value = [...previous, caption].slice(-2)
-  if (liveCaptionClearTimer !== null) window.clearTimeout(liveCaptionClearTimer)
-  liveCaptionClearTimer = window.setTimeout(() => {
-    liveCaptions.value = []
-    liveCaptionClearTimer = null
-  }, message.isCompleted === true ? 9000 : 5000)
+  // Keep the current call's transcript visible in the side rail.  Repeated
+  // partial updates replace the same segment and the bounded history prevents
+  // long calls from growing memory without limit.
+  liveCaptions.value = [...previous, caption].slice(-120)
 }

 function handleTranscriberMessage(
@@ -1421,7 +1571,6 @@ async function stopTranscription(
    transcriptionSessionId = ''
    acknowledgedSegmentIds.clear()
    pendingSegments.clear()
-    clearLiveCaptions()
  })().finally(() => {
    transcriptionStopPromise = null
  })
@@ -1720,6 +1869,7 @@ async function open(config: DoctorCallConfig): Promise<void> {
  activeConfig = normalizeConfig(config)
  mode.value = activeConfig.mode
  patientName.value = activeConfig.patientName
+  patientCase.value = activeConfig.patientCase
  messages.value = []
  nextReqMessageID = ''
  hasMoreMessages.value = false
@@ -1805,12 +1955,14 @@ createApp(App, {
  transcriptionState: readonly(transcriptionState),
  localRecordingState: readonly(localRecordingState),
  liveCaptions: readonly(liveCaptions),
+  patientCase: readonly(patientCase),
  onSendText: sendText,
  onSendAttachment: sendAttachment,
  onLoadMore: () => loadMessages(true),
  onReconnectChat: reconnectChat,
  onStartVideo: startVideo,
  onHangup: hangup,
+  onOpenDiagnosis: openDiagnosis,
  onSaveScreenshot: saveScreenshot,
 }).mount('#app')

@@ -272,6 +272,8 @@ button:disabled { cursor: not-allowed; opacity: .55; }

 .video-layer {
  position: relative;
+  display: grid;
+  grid-template-columns: minmax(0, 1fr);
  width: 100%;
  height: 100%;
  min-height: 420px;
@@ -281,8 +283,21 @@ button:disabled { cursor: not-allowed; opacity: .55; }
    radial-gradient(circle at 50% 35%, rgba(60, 86, 130, .28), transparent 38%),
    #090d14;
 }
+.video-layer--with-rail {
+  grid-template-columns: minmax(0, 1fr) clamp(330px, 31vw, 380px);
+}
 .video-layer--overlay { position: fixed; z-index: 1000; inset: 0; }

+.video-stage {
+  position: relative;
+  min-width: 0;
+  min-height: 0;
+  overflow: hidden;
+  background:
+    radial-gradient(circle at 50% 35%, rgba(60, 86, 130, .28), transparent 38%),
+    #090d14;
+}
+
 .call-kit,
 .video-layer :is(.TUICallKit-desktop, .TUICallKit-mobile, #tuicallkit-id) {
  width: 100% !important;
@@ -336,40 +351,249 @@ button:disabled { cursor: not-allowed; opacity: .55; }
 }
 .live-status .status-dot { width: 7px; height: 7px; margin: 0; box-shadow: none; }

-.live-captions {
-  position: absolute;
-  z-index: 38;
-  left: 50%;
-  bottom: 92px;
+.consultation-rail {
+  position: relative;
+  z-index: 55;
  display: grid;
-  gap: 7px;
-  width: min(820px, calc(100% - 360px));
-  transform: translateX(-50%);
-  pointer-events: none;
+  grid-template-rows: auto minmax(0, 1.08fr) minmax(0, .92fr);
+  min-width: 0;
+  min-height: 0;
+  overflow: hidden;
+  border-left: 1px solid #dce3f0;
+  color: #15233a;
+  background: #f6f8fc;
+  box-shadow: -16px 0 38px rgba(4, 12, 26, .16);
 }
-.live-captions p {
+.consultation-rail__header {
  display: grid;
-  grid-template-columns: auto minmax(0, 1fr);
-  gap: 10px;
-  align-items: start;
-  width: fit-content;
-  max-width: 100%;
-  margin: 0 auto;
-  padding: 8px 14px;
-  border: 1px solid rgba(255, 255, 255, .2);
-  border-radius: 10px;
+  grid-template-columns: 42px minmax(0, 1fr) auto;
+  gap: 11px;
+  align-items: center;
+  min-height: 74px;
+  padding: 13px 16px;
+  border-bottom: 1px solid #e2e7f1;
+  background: #fff;
+}
+.consultation-rail__avatar {
+  display: grid;
+  place-items: center;
+  width: 42px;
+  height: 42px;
+  border-radius: 13px;
  color: #fff;
-  background: rgba(9, 13, 20, .78);
-  box-shadow: 0 6px 24px rgba(0, 0, 0, .2);
-  font-size: 16px;
-  line-height: 1.55;
-  backdrop-filter: blur(8px);
+  background: #5761f4;
+  font-size: 17px;
+  font-weight: 700;
 }
-.live-captions strong {
-  color: #aeb8ff;
+.consultation-rail__identity {
+  display: grid;
+  gap: 3px;
+  min-width: 0;
+}
+.consultation-rail__identity strong {
+  overflow: hidden;
+  color: #111f46;
+  font-size: 16px;
+  line-height: 1.3;
+  text-overflow: ellipsis;
  white-space: nowrap;
 }
-.live-captions span { min-width: 0; word-break: break-word; }
+.consultation-rail__identity span {
+  overflow: hidden;
+  color: #7886a3;
+  font-size: 11px;
+  text-overflow: ellipsis;
+  white-space: nowrap;
+}
+.diagnosis-chip {
+  padding: 5px 7px;
+  border-radius: 6px;
+  color: #4a56d5;
+  background: #eef0ff;
+  font-size: 10px;
+  font-weight: 700;
+  font-variant-numeric: tabular-nums;
+  white-space: nowrap;
+}
+.consultation-rail__actions {
+  display: grid;
+  flex: 0 0 auto;
+  justify-items: end;
+  gap: 5px;
+}
+.open-diagnosis-button {
+  display: inline-flex;
+  align-items: center;
+  gap: 4px;
+  min-height: 28px;
+  padding: 5px 8px;
+  border: 1px solid #cfd5ff;
+  border-radius: 7px;
+  color: #3f4bc5;
+  background: #fff;
+  font-size: 11px;
+  font-weight: 700;
+  white-space: nowrap;
+}
+.open-diagnosis-button:hover,
+.open-diagnosis-button:focus-visible {
+  border-color: #6874e7;
+  background: #f3f4ff;
+  outline: none;
+}
+.open-diagnosis-button:disabled { cursor: not-allowed; opacity: .55; }
+.case-panel,
+.transcript-panel {
+  display: grid;
+  grid-template-rows: auto minmax(0, 1fr);
+  min-height: 0;
+  overflow: hidden;
+}
+.case-panel { border-bottom: 1px solid #dde4f0; }
+.rail-section-heading {
+  display: flex;
+  align-items: center;
+  justify-content: space-between;
+  gap: 12px;
+  min-height: 48px;
+  padding: 10px 16px;
+  border-bottom: 1px solid #e5e9f2;
+  background: rgba(255, 255, 255, .72);
+}
+.rail-section-heading > div {
+  display: flex;
+  align-items: center;
+  gap: 8px;
+}
+.rail-section-heading h2 {
+  margin: 0;
+  color: #1b2945;
+  font-size: 14px;
+  font-weight: 700;
+  letter-spacing: -.01em;
+}
+.rail-section-heading > span {
+  overflow: hidden;
+  max-width: 154px;
+  color: #8b97ad;
+  font-size: 10px;
+  text-overflow: ellipsis;
+  white-space: nowrap;
+}
+.rail-section-heading__index {
+  color: #6874e7;
+  font-family: "Cascadia Mono", "SFMono-Regular", Consolas, monospace;
+  font-size: 10px;
+  font-weight: 700;
+}
+.case-panel__content,
+.live-captions {
+  min-height: 0;
+  overflow-y: auto;
+  overscroll-behavior: contain;
+  scrollbar-color: #b9c3d5 transparent;
+  scrollbar-width: thin;
+}
+.case-panel__content { padding: 5px 16px 14px; }
+.case-field-list { display: grid; }
+.case-field {
+  display: grid;
+  grid-template-columns: 72px minmax(0, 1fr);
+  gap: 10px;
+  padding: 10px 0;
+  border-bottom: 1px solid #e5e9f2;
+}
+.case-field:last-child { border-bottom: 0; }
+.case-field > span {
+  padding-top: 2px;
+  color: #7a879d;
+  font-size: 11px;
+  font-weight: 600;
+}
+.case-field p {
+  margin: 0;
+  color: #263551;
+  font-size: 12px;
+  line-height: 1.55;
+  overflow-wrap: anywhere;
+  white-space: pre-wrap;
+}
+.case-field--risk > span { color: #bc3e4e; }
+.case-field--risk p {
+  color: #9f3141;
+  font-weight: 600;
+}
+.live-captions {
+  display: grid;
+  align-content: start;
+  gap: 9px;
+  padding: 12px 14px 18px;
+  background: #f2f5fa;
+}
+.caption-entry {
+  padding: 10px 11px;
+  border-left: 2px solid #6571e8;
+  border-radius: 0 9px 9px 0;
+  background: #fff;
+  box-shadow: 0 4px 14px rgba(30, 46, 76, .045);
+}
+.caption-entry--partial { border-left-color: #9ca6b7; opacity: .78; }
+.caption-entry header {
+  display: flex;
+  align-items: center;
+  justify-content: space-between;
+  gap: 10px;
+  margin-bottom: 5px;
+}
+.caption-entry strong {
+  color: #4a56d5;
+  font-size: 11px;
+}
+.caption-entry time {
+  color: #9aa5b7;
+  font-size: 10px;
+  font-variant-numeric: tabular-nums;
+}
+.caption-entry p {
+  margin: 0;
+  color: #24334e;
+  font-size: 13px;
+  line-height: 1.58;
+  overflow-wrap: anywhere;
+  white-space: pre-wrap;
+}
+.transcript-state {
+  position: relative;
+  padding-left: 12px;
+}
+.transcript-state::before {
+  position: absolute;
+  top: 50%;
+  left: 0;
+  width: 6px;
+  height: 6px;
+  transform: translateY(-50%);
+  border-radius: 50%;
+  background: #a5adbb;
+  content: "";
+}
+.transcript-state--active { color: #168260 !important; }
+.transcript-state--active::before {
+  background: #24b987;
+  box-shadow: 0 0 0 3px rgba(36, 185, 135, .12);
+}
+.rail-empty {
+  display: grid;
+  gap: 5px;
+  align-content: center;
+  min-height: 112px;
+  padding: 18px;
+  color: #8a96aa;
+  text-align: center;
+}
+.rail-empty strong { color: #53617a; font-size: 12px; }
+.rail-empty span { font-size: 11px; line-height: 1.55; }
+.rail-empty--case { min-height: 100%; }

 .video-actions {
  position: absolute;
@@ -494,8 +718,54 @@ button:disabled { cursor: not-allowed; opacity: .55; }
  .consultation-shell { min-width: 620px; }
  .message-list { padding-inline: 18px; }
  .message-bubble { max-width: 82%; }
-  .live-captions { width: calc(100% - 36px); bottom: 88px; }
-  .live-captions p { font-size: 14px; }
+}
+
+@media (max-width: 980px) {
+  .consultation-shell { min-width: 760px; }
+  .video-layer--with-rail { grid-template-columns: minmax(0, 1fr) 310px; }
+  .video-actions {
+    right: 12px;
+    bottom: 14px;
+    left: 12px;
+    flex-wrap: wrap;
+    justify-content: flex-end;
+  }
+  .recording-status {
+    flex-basis: 100%;
+    width: fit-content;
+    margin-left: auto;
+    font-size: 11px;
+  }
+  .consultation-rail__header { padding-inline: 12px; }
+  .diagnosis-chip { display: none; }
+  .case-panel__content { padding-inline: 12px; }
+  .rail-section-heading { padding-inline: 12px; }
+}
+
+@media (max-width: 700px) {
+  .consultation-shell { min-width: 0; }
+  .video-layer,
+  .video-stage { min-height: 280px; }
+  .video-layer--with-rail { grid-template-columns: minmax(0, 1fr); }
+  .consultation-rail { display: none; }
+  .video-actions {
+    right: 10px;
+    bottom: 10px;
+    left: auto;
+    gap: 6px;
+  }
+  .recording-status,
+  .capture-button { display: none; }
+  .video-actions button {
+    padding: 8px 11px;
+    border-radius: 8px;
+    font-size: 11px;
+  }
+  .live-status {
+    top: 10px;
+    padding: 7px 10px;
+    font-size: 11px;
+  }
 }

 /* Doctor workstation blue-white subwindow contract.  Video pixels remain on
@@ -1010,8 +1010,8 @@ class DiagnosisController extends BaseAdminController
            }
            if ($result === null) {
                $emit('error', [
-                    'code' => 'AI_ASSISTANT_FAILED',
-                    'message' => 'AI 助手暂时不可用，请稍后重试',
+                    'code' => DiagnosisAiLogic::getAssistantErrorCode(),
+                    'message' => DiagnosisAiLogic::getError(),
                ]);
            } else {
                $emit('done', $result);
@@ -18,6 +18,9 @@ use think\facade\Log;
 */
 class DiagnosisAiLogic extends BaseLogic
 {
+    /** @var string Safe machine-readable code for the current assistant request. */
+    private static $assistantErrorCode = 'AI_ASSISTANT_FAILED';
+
    private const PROMPT_VERSION = 'patient-context-case-explain-v2';

    private const ASSISTANT_PROMPT_VERSION = 'patient-context-assistant-v2';
@@ -354,6 +357,7 @@ class DiagnosisAiLogic extends BaseLogic
        int $adminId,
        array $adminInfo
    ): ?array {
+        self::$assistantErrorCode = 'AI_ASSISTANT_FAILED';
        $diagnosis = self::loadAuthorizedDiagnosis(
            $diagnosisId,
            $adminId,
@@ -433,6 +437,14 @@ class DiagnosisAiLogic extends BaseLogic
        $diagnosisId = (int) ($prepared['diagnosis_id'] ?? 0);
        $profile = (string) ($prepared['profile'] ?? '');
        $adminId = (int) ($prepared['admin_id'] ?? 0);
+        $deliveredDelta = false;
+        $forwardDelta = static function (string $delta) use (&$deliveredDelta, $onDelta) {
+            $accepted = $onDelta($delta);
+            if ($accepted !== false) {
+                $deliveredDelta = true;
+            }
+            return $accepted;
+        };

        try {
            $result = DifyChatService::streamChat(
@@ -440,7 +452,7 @@ class DiagnosisAiLogic extends BaseLogic
                is_array($prepared['inputs'] ?? null) ? $prepared['inputs'] : [],
                (string) ($prepared['query'] ?? ''),
                (string) ($prepared['user'] ?? ''),
-                $onDelta,
+                $forwardDelta,
                $shouldAbort,
                is_array($prepared['files'] ?? null) ? $prepared['files'] : []
            );
@@ -452,6 +464,7 @@ class DiagnosisAiLogic extends BaseLogic
                $e,
                (string) ($prepared['task'] ?? '')
            );
+            self::$assistantErrorCode = 'UPSTREAM_UNAVAILABLE';
            self::setError('AI 助手暂时不可用，请稍后重试');
            return null;
        }
@@ -464,6 +477,47 @@ class DiagnosisAiLogic extends BaseLogic
                (string) ($prepared['task'] ?? ''),
                is_array($result) ? $result : []
            );
+
+            // Some Dify-compatible gateways accept blocking chat but reject or
+            // incompletely terminate streaming responses.  Before any delta has
+            // reached the doctor it is safe to make one blocking compatibility
+            // attempt; after a delta, retrying could duplicate clinical text.
+            $streamErrorCode = strtoupper(trim((string) ($result['error_code'] ?? '')));
+            if (
+                !$deliveredDelta
+                && in_array(
+                    $streamErrorCode,
+                    ['UPSTREAM_REJECTED', 'INCOMPLETE_RESPONSE', 'EMPTY_RESPONSE'],
+                    true
+                )
+            ) {
+                try {
+                    $result = DifyChatService::chat(
+                        $profile,
+                        is_array($prepared['inputs'] ?? null) ? $prepared['inputs'] : [],
+                        (string) ($prepared['query'] ?? ''),
+                        (string) ($prepared['user'] ?? ''),
+                        is_array($prepared['files'] ?? null) ? $prepared['files'] : []
+                    );
+                } catch (\Throwable $e) {
+                    self::logAssistantFailure(
+                        $diagnosisId,
+                        $profile,
+                        $adminId,
+                        $e,
+                        (string) ($prepared['task'] ?? '')
+                    );
+                }
+                if (empty($result['ok'])) {
+                    self::logAssistantUpstreamError(
+                        $diagnosisId,
+                        $profile,
+                        $adminId,
+                        (string) ($prepared['task'] ?? ''),
+                        is_array($result) ? $result : []
+                    );
+                }
+            }
        }

        return self::formatAssistantResult($prepared, $result);
@@ -480,6 +534,7 @@ class DiagnosisAiLogic extends BaseLogic
            // 附带上游错误码，让医生反馈时管理员能直接定位是配置、体积还是上游拒绝。
            $message = (string) ($result['error'] ?? 'AI 助手暂时不可用，请稍后重试');
            $errorCode = trim((string) ($result['error_code'] ?? ''));
+            self::$assistantErrorCode = self::normaliseAssistantErrorCode($errorCode);
            if ($errorCode !== '') {
                $message .= '（' . $errorCode . '）';
            }
@@ -488,6 +543,7 @@ class DiagnosisAiLogic extends BaseLogic
        }
        $content = self::cleanText($result['content'] ?? '', self::MAX_REPORT_LENGTH, true);
        if ($content === '') {
+            self::$assistantErrorCode = 'EMPTY_RESPONSE';
            self::setError('AI 助手未返回内容，请重试');
            return null;
        }
@@ -520,6 +576,20 @@ class DiagnosisAiLogic extends BaseLogic
        return $payload;
    }

+    /** Return a safe code for the current SSE terminal error event. */
+    public static function getAssistantErrorCode(): string
+    {
+        return self::normaliseAssistantErrorCode(self::$assistantErrorCode);
+    }
+
+    private static function normaliseAssistantErrorCode(string $code): string
+    {
+        $code = strtoupper(trim($code));
+        return preg_match('/^[A-Z][A-Z0-9_]{2,63}$/', $code) === 1
+            ? $code
+            : 'AI_ASSISTANT_FAILED';
+    }
+
    /** @return array<string,mixed>|null */
    private static function parsePrescriptionDraft(string $content): ?array
    {
@@ -91,6 +91,9 @@ class DifyChatService
            );
            $lastResponse = null;
            $lastSpec = [];
+            // 协议回退会把最初的“附件被拒”换成另一协议的状态码，因此降级判断
+            // 必须记住本轮出现过的附件拒绝信号，而不能只看最后一次响应。
+            $fileRejected = false;

            foreach ($requestSpecs as $index => $requestSpec) {
                $elapsedSeconds = (int) floor(microtime(true) - $startedAt);
@@ -111,11 +114,12 @@ class DifyChatService
                );
                $lastResponse = $response;
                $lastSpec = $requestSpec;
+                $fileRejected = $fileRejected || self::isFileRejection($response, $attempt['files']);

                // /v1 在两种协议中都是合法基址。仅在明确表示路径不存在时尝试另一协议，
                // 避免因业务参数错误而重复提交同一份临床数据。
                $hasFallback = isset($requestSpecs[$index + 1]);
-                if ($hasFallback && in_array($response['http_code'], [404, 405, 501], true)) {
+                if ($hasFallback && self::shouldTryNextProtocol($response, false)) {
                    continue;
                }
                break;
@@ -128,7 +132,7 @@ class DifyChatService
                return $formatted;
            }
            // 附件整体被拒时退回纯文本重试，附件清单已在下一轮尝试中补齐。
-            if (!self::shouldRetryWithoutFiles((int) $lastResponse['http_code'], $attempt['files'])) {
+            if (!$fileRejected) {
                return $formatted;
            }
        }
@@ -203,6 +207,9 @@ class DifyChatService
            );
            $lastResponse = null;
            $lastSpec = [];
+            // 协议回退会把最初的“附件被拒”换成另一协议的状态码，因此降级判断
+            // 必须记住本轮出现过的附件拒绝信号，而不能只看最后一次响应。
+            $fileRejected = false;

            foreach ($requestSpecs as $index => $requestSpec) {
                $elapsedSeconds = (int) floor(microtime(true) - $startedAt);
@@ -226,13 +233,13 @@ class DifyChatService
                );
                $lastResponse = $response;
                $lastSpec = $requestSpec;
+                $fileRejected = $fileRejected || self::isFileRejection($response, $attempt['files']);

                // 只在尚未向下游发送任何文本、且明确为路径不支持时尝试另一协议。
                $hasFallback = isset($requestSpecs[$index + 1]);
                if (
                    $hasFallback
-                    && empty($response['emitted'])
-                    && in_array($response['http_code'], [404, 405, 501], true)
+                    && self::shouldTryNextProtocol($response, true)
                ) {
                    continue;
                }
@@ -246,9 +253,6 @@ class DifyChatService
                return $formatted;
            }
            // 已经推给医生的文本不能重复输出，因此只在一个字都没发出去时才降级重试。
-            // 附件不可达时 Dify 会在 200 流里发 event:error，同样按附件问题降级。
-            $fileRejected = self::shouldRetryWithoutFiles((int) $lastResponse['http_code'], $attempt['files'])
-                || (!empty($lastResponse['upstream_error']) && $attempt['files'] !== []);
            if (!empty($lastResponse['emitted']) || !$fileRejected) {
                return $formatted;
            }
@@ -458,6 +462,26 @@ class DifyChatService
        return $files !== [] && in_array($httpCode, self::FILE_REJECTION_CODES, true);
    }

+    /**
+     * 判断一次上游响应是否属于“这批附件我处理不了”。
+     *
+     * 除了 4xx 状态码，Dify 拉不到附件时会在 200 的 SSE 流里发 event:error，
+     * 这两种形态都必须触发去掉附件的降级重试。
+     *
+     * @param array<string,mixed> $response
+     * @param array<int,array<string,string>> $files
+     */
+    private static function isFileRejection(array $response, array $files): bool
+    {
+        if ($files === [] || (int) ($response['errno'] ?? 0) !== 0) {
+            return false;
+        }
+        if (self::shouldRetryWithoutFiles((int) ($response['http_code'] ?? 0), $files)) {
+            return true;
+        }
+        return !empty($response['upstream_error']);
+    }
+
    /**
     * 把无法随请求送达的附件写成显式清单。模型必须知道这些资料存在但读不到，
     * 才不会把“没看到”当成“没有”。
@@ -509,6 +533,30 @@ class DifyChatService
        return $baseUrl . '/v1/' . $endpoint;
    }

+    /**
+     * Decide whether an ambiguous base URL should be tried with the other wire
+     * protocol.  A 400/415/422 response cannot have started generation, and a
+     * 2xx stream with no delivered delta but no valid terminal frame is also
+     * safe to retry.  Authentication, rate-limit and server failures retain
+     * their original diagnosis instead of being hidden by a second request.
+     *
+     * @param array<string,mixed> $response
+     */
+    private static function shouldTryNextProtocol(array $response, bool $streaming): bool
+    {
+        if ((int) ($response['errno'] ?? 0) !== 0) {
+            return false;
+        }
+        $httpCode = (int) ($response['http_code'] ?? 0);
+        if (in_array($httpCode, [400, 404, 405, 415, 422, 501], true)) {
+            return true;
+        }
+        if (!$streaming || $httpCode < 200 || $httpCode >= 300 || !empty($response['emitted'])) {
+            return false;
+        }
+        return !empty($response['upstream_error']) || empty($response['finished']);
+    }
+
    private static function isValidBaseUrl(string $baseUrl): bool
    {
        if (preg_match('/[\x00-\x20\x7f]/', $baseUrl)) {
@@ -100,11 +100,14 @@ assistantStreamExpect(
 );
 assistantStreamExpect(
    str_contains($controller, "'text' => \$delta")
-        && str_contains($controller, "'code' => 'AI_ASSISTANT_FAILED'")
+        && str_contains($controller, 'DiagnosisAiLogic::getAssistantErrorCode()')
+        && str_contains($controller, 'DiagnosisAiLogic::getError()')
        && str_contains($controller, 'ignore_user_abort(true)')
        && str_contains($controller, 'connection_aborted() === 1')
-        && !str_contains($controller, "DiagnosisAiLogic::getError()\n                ]"),
-    'delta carries text, disconnects abort upstream, and errors use a generic prompt-free payload'
+        && str_contains($logic, '!$deliveredDelta')
+        && str_contains($logic, "['UPSTREAM_REJECTED', 'INCOMPLETE_RESPONSE', 'EMPTY_RESPONSE']")
+        && str_contains($logic, 'DifyChatService::chat('),
+    'delta carries text, disconnects abort upstream, and pre-delta stream failures safely fall back once'
 );
 assistantStreamExpect(
    str_contains($logic, 'DifyChatService::chat(')
@@ -95,6 +95,37 @@ $explicitOpenAi = callDifyStreamPrivate('buildRequestSpecs', [
 difyStreamExpect(count($explicitDify) === 1 && $explicitDify[0]['protocol'] === 'dify', 'explicit Dify endpoint never changes protocol');
 difyStreamExpect(count($explicitOpenAi) === 1 && $explicitOpenAi[0]['protocol'] === 'openai', 'explicit OpenAI endpoint never changes protocol');

+$retryableStream = [
+    'errno' => 0,
+    'http_code' => 200,
+    'emitted' => false,
+    'upstream_error' => true,
+    'finished' => false,
+];
+difyStreamExpect(
+    callDifyStreamPrivate('shouldTryNextProtocol', [$retryableStream, true]) === true,
+    'a terminal-free stream error before any delta tries the alternate protocol'
+);
+$retryableStream['emitted'] = true;
+difyStreamExpect(
+    callDifyStreamPrivate('shouldTryNextProtocol', [$retryableStream, true]) === false,
+    'an emitted delta forbids protocol retry'
+);
+difyStreamExpect(
+    callDifyStreamPrivate('shouldTryNextProtocol', [[
+        'errno' => 0,
+        'http_code' => 400,
+    ], false]) === true,
+    'an ambiguous endpoint rejected before generation tries the alternate protocol'
+);
+difyStreamExpect(
+    callDifyStreamPrivate('shouldTryNextProtocol', [[
+        'errno' => 0,
+        'http_code' => 401,
+    ], true]) === false,
+    'credential failures are not hidden by protocol retry'
+);
+
 $difyWire = ": ping\r\n\r\n"
    . "data: {\"event\":\"message\",\"answer\":\"你\",\"message_id\":\"msg-safe\"}\r\n\r\n"
    . "data: {\"event\":\"agent_message\",\"answer\":\"好\"}\r\n\r\n"
@@ -192,6 +192,40 @@ expectSame(false, callPrivate('shouldRetryWithoutFiles', [400, []]), 'a text-onl
 expectSame(false, callPrivate('shouldRetryWithoutFiles', [401, $capped['kept']]), 'a credential failure is not retried');
 expectSame(false, callPrivate('shouldRetryWithoutFiles', [500, $capped['kept']]), 'an upstream outage is not retried here');

+// 协议回退会把最初的“附件被拒”换成另一协议的状态码（Dify 400 -> OpenAI 404），
+// 降级判断必须按每次响应累计，否则去掉附件的重试永远不会发生。
+expectSame(
+    true,
+    callPrivate('isFileRejection', [['errno' => 0, 'http_code' => 400], $capped['kept']]),
+    'an attachment rejection is recognised on the response that carried it'
+);
+expectSame(
+    false,
+    callPrivate('isFileRejection', [['errno' => 0, 'http_code' => 404], $capped['kept']]),
+    'the fallback protocol 404 is not itself an attachment rejection'
+);
+expectSame(
+    true,
+    callPrivate('isFileRejection', [
+        ['errno' => 0, 'http_code' => 200, 'upstream_error' => true],
+        $capped['kept'],
+    ]),
+    'a 200 stream carrying event:error counts as an attachment rejection'
+);
+expectSame(
+    false,
+    callPrivate('isFileRejection', [
+        ['errno' => 0, 'http_code' => 200, 'upstream_error' => true],
+        [],
+    ]),
+    'a text-only request never degrades further'
+);
+expectSame(
+    false,
+    callPrivate('isFileRejection', [['errno' => 28, 'http_code' => 0], $capped['kept']]),
+    'a transport failure is not mistaken for an attachment rejection'
+);
+
 // Dify 的 inputs 必须是 JSON 对象。PHP 空数组会被编码成 []，上游以
 // invalid_param 拒绝整单——空 inputs 的调用方会 100% 失败。
 $emptyInputs = callPrivate('buildRequestSpecs', [